Provider Demographics
NPI:1134098973
Name:PAGE, KRYSTAL (CM/CBRS)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:
Last Name:PAGE
Suffix:
Gender:F
Credentials:CM/CBRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 SHOUP AVE W STE F
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5043
Mailing Address - Country:US
Mailing Address - Phone:406-223-3259
Mailing Address - Fax:
Practice Address - Street 1:496 SHOUP AVE W STE F
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5043
Practice Address - Country:US
Practice Address - Phone:406-223-3259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-31
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator