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Organization

RIVERSIDE FAMILY HEALTH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRYSTAL LEANN LANDRUM CRNP (CEO)
(256) 355-7665
Entity
Organization

Contact information

Practice address
1501 7TH ST SE STE A, DECATUR, AL 35601-3375
(256) 355-7665
(256) 686-3241
Mailing address
1501 7TH ST SE STE A, DECATUR, AL 35601-3375
(256) 355-7665
(256) 686-3241

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-093034
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12404856
CAQH
AL
05
138745
AL
05
140473
AL
01
51126863
BCBS
AL
Enumeration date
05/30/2012
Last updated
07/31/2025
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