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General NPI Number Information
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NPI Number | 1073184396
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Entity Type | Individual
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Provider Name | CRYSTAL MARIE KOLLING APRN
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Gender | Female
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Dates
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Enumeration Date | 07/07/2021
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 270 N US HIGHWAY 701 BYP
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City | TABOR CITY
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State | NC
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Zip | 28463-9324
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Country | US
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Telephone | 910-653-1901
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Fax | 910-320-8435
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Provider Business Mailing Address
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Address Line | PO BOX 187
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City | FAISON
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State | NC
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Zip | 28341-0187
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Country | US
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Telephone | 910-267-2042
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Fax | 855-996-9090
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5020044
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5020044
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 6578490-4405
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26579
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License Number State | SC
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