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Individual

CRYSTAL DAWN TROUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
300 E 20TH ST, HOPE, AR 71801-8217
(870) 777-9051
Mailing address
2904 ARKANSAS BLVD, TEXARKANA, AR 71854-2536

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
L054117
AR
171M00000X
Case Manager/Care Coordinator
Primary
AR

Other

Enumeration date
08/20/2020
Last updated
08/20/2020
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