Provider Demographics
NPI:1558757518
Name:VOYLES, CRYSTAL (LPN)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:VOYLES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:
Other - Last Name:CHITWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1639 BRUCE SMITH PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-7691
Mailing Address - Country:US
Mailing Address - Phone:417-257-1833
Mailing Address - Fax:417-256-0488
Practice Address - Street 1:1639 BRUCE SMITH PKWY
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-7691
Practice Address - Country:US
Practice Address - Phone:417-257-1833
Practice Address - Fax:417-256-0488
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010002141164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse