Individual
CRYSTAL BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
555 S TELSHOR BLVD STE 100B, LAS CRUCES, NM 88011-3644
(435) 232-5911
Mailing address
161 E 200 S, RICHMOND, UT 84333-1614
(435) 232-5911
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
8054927-3102
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
1073748
TX
Other
Enumeration date
01/12/2022
Last updated
11/10/2023
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