Healthcare Provider Details

I. General information

NPI: 1104254689
Provider Name (Legal Business Name): CRYSTAL ALEXANDER FINNEY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2013
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6208 FIELDBROOK CIR
MC CALLA AL
35111-1180
US

IV. Provider business mailing address

6208 FIELDBROOK CIR
MC CALLA AL
35111-1180
US

V. Phone/Fax

Practice location:
  • Phone: 706-575-7170
  • Fax:
Mailing address:
  • Phone: 706-575-7170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-116187
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: