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NPI Code Detail

MEDICARE: MS. CRYSTAL RENEE NADI

MEDICARE: MS. CRYSTAL RENEE NADI
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
13747P1801XPersonal Care Attendant
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1417564386
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CRYSTAL RENEE NADI
Provider Business Mailing Address
First Line : 2558 WINFIELD RD
Second Line :
City : SAINT ALBANS
State : WV
Zip : 25177-7804
Country : US
Telephone Number : 304-755-2385
Fax Number : 304-755-2389
Provider Business Practice Location Address
First Line : 2558 WINFIELD RD
Second Line :
City : SAINT ALBANS
State : WV
Zip : 25177-7804
Country : US
Telephone Number : 304-755-2385
Fax Number : 304-755-2389
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2020
Last Update Date : 07/01/2021

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