Provider Demographics
NPI:1497536932
Name:ERWIN, KRYSTLE (RN)
Entity Type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:
Last Name:ERWIN
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 1:3881 E MARATHON DR
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89061-0110
Mailing Address - Country:US
Mailing Address - Phone:775-513-6206
Mailing Address - Fax:
Practice Address - Street 1:1280 E CALVADA BLVD
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5693
Practice Address - Country:US
Practice Address - Phone:775-910-9811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV821051163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse