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NPI 1336308279

NPI 1336308279 : CRYSTAL NARCISSE MD : LOUISVILLE, KY

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General NPI Number Information
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    NPI Number           |    1336308279
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    Entity Type          |    Individual 
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    Provider Name        |    CRYSTAL NARCISSE MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/05/2008
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    Last Update Date     |    11/01/2019
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Provider Practice Location Address
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    Address Line         |    213 N HURSTBOURNE PKWY 
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40222-5139
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    Country              |    US
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    Telephone            |    502-327-5135
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    Fax                  |    502-327-9475
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Provider Business Mailing Address
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    Address Line         |    PO BOX 776351 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60677-6351
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    Country              |    US
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    Telephone            |    502-588-9490
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    Fax                  |    502-272-5116
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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        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    45208
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    License Number State |    KY
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Taxonomy #2
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    45208
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    License Number State |    KY
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