Provider Demographics
NPI:1033409396
Name:CRYSTAL, KIMBERLY LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LYNN
Last Name:CRYSTAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1501
Mailing Address - Country:US
Mailing Address - Phone:302-313-2600
Mailing Address - Fax:302-644-1218
Practice Address - Street 1:1305 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1501
Practice Address - Country:US
Practice Address - Phone:302-313-2600
Practice Address - Fax:302-644-1218
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0023007163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse