Individual
CRYSTAL LITES SPEEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1000 PINE ST, ER, TEXARKANA, TX 75501-5100
(903) 798-8880
Mailing address
1000 PINE ST, TEXARKANA, TX 75501-5100
(903) 798-8880
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
346176
NY
363L00000X
Nurse Practitioner
AP07951
LA
363L00000X
Nurse Practitioner
Primary
AP127111
TX
Other
Enumeration date
07/15/2014
Last updated
08/20/2021
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