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General NPI Number Information
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NPI Number | 1083564249
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Entity Type | Individual
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Provider Name | CRISTA CORRAL
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Gender | Female
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 402 GRAYBEAL AVE
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City | WEST JEFFERSON
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State | NC
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Zip | 28694-9730
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Country | US
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Telephone | 336-846-2265
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 THORNCREST DR
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City | FLETCHER
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State | NC
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Zip | 28732-9294
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Country | US
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Telephone | 828-708-2834
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5023879
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License Number State | NC
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