Provider Demographics
NPI:1659490845
Name:MORRISON, CRYSTAL LYNN (RD, LD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:LYNN
Last Name:MORRISON
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:MS
Other - First Name:CRYSTAL
Other - Middle Name:LYNN
Other - Last Name:ALBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 NW LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-1441
Mailing Address - Country:US
Mailing Address - Phone:515-965-6822
Mailing Address - Fax:
Practice Address - Street 1:3800 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-3402
Practice Address - Country:US
Practice Address - Phone:515-450-0508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01504133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered