Provider Demographics
NPI:1619383320
Name:FRANK, CHRYSTAL (MS-MPH,RD,LDN)
Entity Type:Individual
Prefix:
First Name:CHRYSTAL
Middle Name:
Last Name:FRANK
Suffix:
Gender:F
Credentials:MS-MPH,RD,LDN
Other - Prefix:MRS
Other - First Name:CHRYSTAL
Other - Middle Name:
Other - Last Name:FRANK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS-MPH,RD,LDN
Mailing Address - Street 1:1 HOSPITAL ROAD
Mailing Address - Street 2:CALLER BOX C-268
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719-9253
Mailing Address - Country:US
Mailing Address - Phone:828-497-9163
Mailing Address - Fax:828-497-1723
Practice Address - Street 1:1 HOSPITAL ROAD
Practice Address - Street 2:CALLER BOX C-268
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719-9253
Practice Address - Country:US
Practice Address - Phone:828-497-9163
Practice Address - Fax:828-497-1723
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1074602133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCL004246OtherNC BOARD OF DIETETICS/NUTRITION