Individual
CRYSTAL NICHOLE MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
151 N ROADRUNNER PKWY APT 103, LAS CRUCES, NM 88011-7021
(575) 571-0142
Mailing address
4708 RIMROCK DR, LAS CRUCES, NM 88012-5076
(575) 571-0142
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN-22297
NM
Other
Enumeration date
02/15/2019
Last updated
02/15/2019
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