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Individual

CRYSTAL C. MENSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSA

Contact information

Practice address
44 MCCOY AVE, SUITE 442, MADISONVILLE, KY 42431-2867
(270) 824-6655
(270) 824-6629
Mailing address
44 MCCOY AVE, SUITE 442, MADISONVILLE, KY 42431-2867
(270) 824-6655
(270) 824-6629

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
SA167
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000530711
ANTHEM PIN #
KY
01
3031
SURGICAL ASSIST ASSOC #
01
SA167
SURGICAL ASSISTANT - KY BD OF MEDICAL LIC #
KY
Enumeration date
08/27/2007
Last updated
08/06/2012
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