Individual
CRYSTINA C FOOTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2525 W UNIVERSITY AVE, SUITE 503, MUNCIE, IN 47303-3421
(765) 288-0441
Mailing address
405 S MORRISON RD, APT 120, MUNCIE, IN 47304-4043
(317) 966-9832
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
465820
MEDICARE PROVIDER
IN
Enumeration date
12/20/2007
Last updated
06/02/2008
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