Provider Demographics
NPI:1437904067
Name:ELKIN, CRYSTAL FAUSTINE
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:FAUSTINE
Last Name:ELKIN
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 1:1340 SANFORD ST
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-1521
Mailing Address - Country:US
Mailing Address - Phone:419-602-6891
Mailing Address - Fax:
Practice Address - Street 1:1340 SANFORD ST
Practice Address - Street 2:
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089-1521
Practice Address - Country:US
Practice Address - Phone:419-602-6891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker