Crystal Bolton, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

332849 Issued in TX

Practice address

1225 E Pleasant Run Rd Apt 1602
Desoto, TX 75115-4248

Phone

(318) 787-4151

NPI assigned

Jun 30, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1821615428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 VIENNA BEND DR",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714572830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E PLEASANT RUN RD APT 1602",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154248",
            "telephone_number": "318-787-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "CRYSTAL",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "332849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BLB Healthcare Services Inc
• Bleu Anesthesia, PLLC
• Bleu Surgical Assistance PLLC
• Bluegreen Industries LLC
• Hareshkumar D Boghara, M.D.
• McKennizie Boodram, LAT
• Misty Booker
• Rachael Bowen, APRN
• Da'Kimbria Bowers,
• Boyce Interprises Inc

• Licensed Vocational Nurse in Desoto, TX
• Providers in Desoto, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.