Individual
MRS. CRYSTAL LYNN MICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, PMHNP-BC
Contact information
Practice address
1 JACK FOSTER DR, SHENANDOAH, IA 51601-4586
(712) 246-7215
(712) 246-7319
Mailing address
1 JACK FOSTER DR, SHENANDOAH, IA 51601-4586
(712) 246-7215
(712) 246-7319
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
141195
IA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G168071
IA
Other
Enumeration date
09/19/2021
Last updated
04/11/2025
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