Individual
TANYA REID CRYSTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1308 8TH ST, RUPERT, ID 83350-1530
(208) 436-4322
(208) 436-1312
Mailing address
1224 8TH STREET, RUPERT, ID 83350-1527
(208) 434-8236
(208) 436-6038
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
35806
ID
363LF0000X
Family Nurse Practitioner
Primary
54387
ID
Other
Enumeration date
05/20/2016
Last updated
08/25/2023
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