Provider Demographics
NPI:1467919837
Name:WARREN, CRYSTAL LYNN (MSN, NNP-BC)
Entity Type:Individual
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First Name:CRYSTAL
Middle Name:LYNN
Last Name:WARREN
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Gender:F
Credentials:MSN, NNP-BC
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Mailing Address - Street 1:804 SERVICE RD STE A109B
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-364-2468
Mailing Address - Fax:517-364-3994
Practice Address - Street 1:1215 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1811
Practice Address - Country:US
Practice Address - Phone:517-364-2468
Practice Address - Fax:517-364-3994
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2023-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704248981363LN0005X, 363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care