Provider Demographics
NPI:1689279267
Name:TRUXALL, CHRYSTAL LYNN (PCA)
Entity Type:Individual
Prefix:MRS
First Name:CHRYSTAL
Middle Name:LYNN
Last Name:TRUXALL
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 PLAIN CITY GEORGESVILLE RD SE
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-9655
Mailing Address - Country:US
Mailing Address - Phone:614-832-5749
Mailing Address - Fax:
Practice Address - Street 1:275 PLAIN CITY GEORGESVILLE RD SE
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-9655
Practice Address - Country:US
Practice Address - Phone:614-832-5749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant