Provider Demographics
NPI:1558137265
Name:VASSELL, CRYSTOL GAYLIA (RN, PMHNP)
Entity Type:Individual
Prefix:MS
First Name:CRYSTOL
Middle Name:GAYLIA
Last Name:VASSELL
Suffix:
Gender:F
Credentials:RN, PMHNP
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Mailing Address - Street 1:3864 LANCEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-6004
Mailing Address - Country:US
Mailing Address - Phone:954-770-0834
Mailing Address - Fax:
Practice Address - Street 1:201 E SAMPLE RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3502
Practice Address - Country:US
Practice Address - Phone:954-786-2380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11029697363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health