Provider Demographics
NPI:1043571714
Name:DUKES, CRYSTAL ANTIONETTE
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ANTIONETTE
Last Name:DUKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-3511
Mailing Address - Country:US
Mailing Address - Phone:202-299-4288
Mailing Address - Fax:
Practice Address - Street 1:1244 1ST ST SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-3511
Practice Address - Country:US
Practice Address - Phone:202-299-4288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC0000374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide