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General NPI Number Information
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NPI Number | 1205134947
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Entity Type | Individual
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Provider Name | ELIZABETH KAY CRISPEN R.PH.
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Gender | Female
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Dates
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Enumeration Date | 03/04/2011
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Last Update Date | 03/04/2011
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Provider Practice Location Address
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Address Line | 421 WYTHE CREEK RD
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City | POQUOSON
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State | VA
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Zip | 23662-1915
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Country | US
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Telephone | 757-868-0297
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Fax |
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Provider Business Mailing Address
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Address Line | 103 PASTURE LN
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City | YORKTOWN
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State | VA
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Zip | 23693-2579
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Country | US
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Telephone | 757-868-5553
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 02022045134513
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26017007A
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License Number State | IN
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