Crystal Wilson
Individual provider Active NPI Specialist · Turkey, NC
NPI 1245787449 · NPPES record last updated Sep 6, 2016
Key facts
- NPI
- 1245787449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 82000291 (NC)
- Practice address
- 1031 Wilmington Rd
Turkey, NC 28393-8405 - Phone
- (910) 379-3675
- NPI assigned
- Sep 6, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82000291 | NC | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 82000291 | NC | Yes |
Addresses
Primary practice location
1031 Wilmington Rd
Turkey, NC 28393-8405
Mailing address
1031 Wilmington Rd
Turkey, NC 28393-8405
Phone (910) 379-3675
Other providers in Turkey, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.