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NPI Code Detail

MEDICARE: KRYSTLE MARGRET WILLEY

MEDICARE: KRYSTLE MARGRET WILLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2372600000XAdult Companion

General Provider Information

NPI Number : 1245092733
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTLE MARGRET WILLEY
Provider Business Mailing Address
First Line : 4625 MOUNTAIN LAKES BLVD
Second Line :
City : REDDING
State : CA
Zip : 96003-1450
Country : US
Telephone Number : 530-246-7172
Fax Number :
Provider Business Practice Location Address
First Line : 4625 MOUNTAIN LAKES BLVD
Second Line :
City : REDDING
State : CA
Zip : 96003-1450
Country : US
Telephone Number : 530-246-7172
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2024
Last Update Date : 12/17/2025

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Directions to “ KRYSTLE MARGRET WILLEY ” Practice Location

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