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Individual

CRYSTAL WYNETTE BLASH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
139 W ANDREWS AVE, HENDERSON, NC 27536-4207
(888) 398-5259
(888) 398-5259
Mailing address
139 W ANDREWS AVE, HENDERSON, NC 27536-4207
(888) 398-5259
(888) 398-5259

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HC5917
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00399432
NC
Enumeration date
06/10/2021
Last updated
07/22/2021
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