Individual
DR. CHRISTINA GRACE CRUMBLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7220 W NATIONAL AVE, WEST ALLIS, WI 53214-4734
(414) 257-8550
Mailing address
7220 W NATIONAL AVE, WEST ALLIS, WI 53214-4734
(414) 257-8550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
63914-20
WI
207Q00000X
Family Medicine Physician
LL 34569
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100046480
—
WI
Enumeration date
06/13/2012
Last updated
08/01/2024
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