Provider Demographics
NPI:1598190837
Name:CRAIN, CRISTEN MORRIS (NP)
Entity Type:Individual
Prefix:
First Name:CRISTEN
Middle Name:MORRIS
Last Name:CRAIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 SILVERSIDE DR
Mailing Address - Street 2:STE 260
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-9005
Mailing Address - Country:US
Mailing Address - Phone:225-490-6301
Mailing Address - Fax:225-765-9539
Practice Address - Street 1:8312 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-8657
Practice Address - Country:US
Practice Address - Phone:225-765-5500
Practice Address - Fax:225-924-1243
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07483363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAAP07483OtherSTATE LICENSE