MEDICARE: CRYSTAL NICHOLSON SPRINGER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174N00000X	Lactation Consultant (Non-RN)	L-110875	NC

General Provider Information

NPI Number	:	1013867571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL NICHOLSON SPRINGER

Provider Business Mailing Address
First Line	:	34876 MANSOURS DR
Second Line	:
City	:	LOCUST GROVE
State	:	VA
Zip	:	22508-3158
Country	:	US
Telephone Number	:	540-321-7464
Fax Number	:

Provider Business Practice Location Address
First Line	:	34876 MANSOURS DR
Second Line	:
City	:	LOCUST GROVE
State	:	VA
Zip	:	22508-3158
Country	:	US
Telephone Number	:	540-321-7464
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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Directions to “ CRYSTAL NICHOLSON SPRINGER ” Practice Location

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