Individual
CRYSTAL BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1225 E PLEASANT RUN RD APT 1602, DESOTO, TX 75115-4248
(318) 787-4151
Mailing address
163 VIENNA BEND DR, NATCHITOCHES, LA 71457-2830
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
332849
TX
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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