Individual
CRYSTAL HACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 859-7222
(317) 859-7220
Mailing address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 807-1266
(317) 859-4269
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71009900A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
677730
GROUP PTAN
IN
Enumeration date
12/26/2019
Last updated
01/19/2024
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