Provider Demographics
NPI:1417981499
Name:CRYSTAL, REJEANA LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:REJEANA
Middle Name:LYNN
Last Name:CRYSTAL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:REJEANA
Other - Middle Name:LYNN
Other - Last Name:FINLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:109 MAPLE ROW BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3853
Mailing Address - Country:US
Mailing Address - Phone:615-822-1922
Mailing Address - Fax:615-822-1926
Practice Address - Street 1:109 MAPLE ROW BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3853
Practice Address - Country:US
Practice Address - Phone:615-822-1922
Practice Address - Fax:615-822-1926
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000000745111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU22614Medicare UPIN
TN3675971Medicare ID - Type Unspecified