Individual
CRYSTAL SHAMBLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
178 PRIVATE ROAD 19423, SOUTH POINT, OH 45680-8831
(606) 331-0643
Mailing address
3325 STATE ROUTE 141, IRONTON, OH 45638-8487
(606) 331-0643
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2043159
KY
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/14/2023
Last updated
05/09/2024
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