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General NPI Number Information
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NPI Number | 1922825884
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Entity Type | Individual
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Provider Name | KRYSTAL MARIE ACTON
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Gender | Female
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 2621 GROVE AVE
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City | RICHMOND
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State | VA
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Zip | 23220-4308
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Country | US
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Telephone | 804-254-9735
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Fax |
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Provider Business Mailing Address
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Address Line | 38 HORSESHOE BND
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City | BUMPASS
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State | VA
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Zip | 23024-2316
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Country | US
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Telephone | 804-347-4245
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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 | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 0024185394
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License Number State | VA
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