Individual
CRYSTAL MARIE LEOFFLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9021 BELLA VERDE CT, MYRTLE BEACH, SC 29579-5110
(843) 516-2024
(843) 796-1319
Mailing address
PO BOX 70157, MYRTLE BEACH, SC 29572-0021
(843) 516-2024
(843) 796-1319
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21877
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP5685
—
SC
Enumeration date
05/31/2018
Last updated
02/26/2021
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