Provider Demographics
NPI:1184950255
Name:FINK, CRYSTAL MULLINS (CPM, LM)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:MULLINS
Last Name:FINK
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:MULLINS
Other - Last Name:MUSSELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPM, LM
Mailing Address - Street 1:1950 ELECTRIC RD STE 1
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-1621
Mailing Address - Country:US
Mailing Address - Phone:540-676-7288
Mailing Address - Fax:540-301-1768
Practice Address - Street 1:1950 ELECTRIC RD STE 1
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1621
Practice Address - Country:US
Practice Address - Phone:540-676-7288
Practice Address - Fax:540-301-1768
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QB0400X, 374J00000X
VA0129000050176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
No374J00000XNursing Service Related ProvidersDoula