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Individual

CRYSTAL J DEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7777 FOREST LN STE C833, DALLAS, TX 75230-2591
(972) 566-4591
Mailing address
7777 FOREST LN STE C833, DALLAS, TX 75230-2591
(972) 566-4591

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP135697
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
805700
RN LICENSE
TX
01
AP135697
LICENSE
TX
Enumeration date
12/04/2017
Last updated
12/04/2017
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