Provider Demographics
NPI:1922628494
Name:MORGAN, CRYSTAL (MSN, FNP-BC, IBCLC)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MSN, FNP-BC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 80TH PL
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5456
Mailing Address - Country:US
Mailing Address - Phone:219-232-6522
Mailing Address - Fax:
Practice Address - Street 1:300 W 80TH PL
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5456
Practice Address - Country:US
Practice Address - Phone:219-232-6522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-24
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INL-136025163WL0100X
IN71013010A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant