Healthcare Provider Details

I. General information

NPI: 1184554784
Provider Name (Legal Business Name): CRYSTAL A HERMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 E BROADWAY RD STE 200
TEMPE AZ
85282-1377
US

IV. Provider business mailing address

8889 E BELL RD STE 205
SCOTTSDALE AZ
85260-1597
US

V. Phone/Fax

Practice location:
  • Phone: 520-208-8534
  • Fax:
Mailing address:
  • Phone: 520-208-8534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: