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General NPI Number Information
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NPI Number | 1598365447
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Entity Type | Individual
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Provider Name | CRYSTAL SHIPLEY HARRISON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/29/2020
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 4419 BUCKINGHAM PL
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City | DULUTH
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State | GA
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Zip | 30096-6207
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Country | US
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Telephone | 435-764-6613
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Fax |
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Provider Business Mailing Address
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Address Line | 4419 BUCKINGHAM PL
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City | DULUTH
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State | GA
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Zip | 30096-6207
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Country | US
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Telephone | 435-764-6613
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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 | 7994725
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License Number State | UT
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