Individual
CRYSTAL E HUMPHRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-7050
(864) 560-0800
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
73007
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7004423
—
NC
05
—
NP0021
—
SC
01
—
P00729159
RAILROAD MEDICARE
SC
01
—
Q318733365
MEDICARE PIN
SC
01
—
Q318734746
MEDICARE PIN
SC
Enumeration date
06/21/2005
Last updated
01/21/2021
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