Healthcare Provider Details

I. General information

NPI: 1861944183
Provider Name (Legal Business Name): CRYSTAL MEIER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2016
Last Update Date: 11/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 TOWN RUN RD
FAIRMOUNT CITY PA
16224-1502
US

IV. Provider business mailing address

121 DOCTORS LN
CLARION PA
16214-8515
US

V. Phone/Fax

Practice location:
  • Phone: 814-275-1600
  • Fax: 814-275-1610
Mailing address:
  • Phone: 814-226-3494
  • Fax: 814-226-3478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP016627
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: