Crystal Adams
Individual provider Active NPI Licensed Practical Nurse · Johnson City, TN
NPI 1609258169 · NPPES record last updated Jun 22, 2015
Key facts
- NPI
- 1609258169
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 81906 (TN)
- Practice address
- 109 W Watauga Ave
Johnson City, TN 37604-5621 - Phone
- (423) 232-2600
- Fax
- (423) 467-3644
- NPI assigned
- Jun 22, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 81906 | TN | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 81906 | TN | Yes |
Addresses
Primary practice location
109 W Watauga Ave
Johnson City, TN 37604-5621
Mailing address
1167 Spratlin Park Dr
PO Box 9054
Gray, TN 37615-6205
Phone (423) 467-3600
Other providers in Johnson City, TN
- Abigail L Abram
- Heather Lea Absalom
- Usama Abu Heija
- Abundant Christian Living Community LLC
- Huthaifah Aburumman
- Don E Adams III
- Ezra Allen Adams
- Joseph A Adams
- Matthew Douglas Adams
- Misty Dawn Adams
All providers in Johnson City, TN · Licensed Practical Nurse in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2015. 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.