Provider Demographics
NPI:1205256260
Name:CRUMPLER, KRISTI (CBRS/ITFS)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:CRUMPLER
Suffix:
Gender:F
Credentials:CBRS/ITFS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 N MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-3100
Mailing Address - Country:US
Mailing Address - Phone:919-330-4802
Mailing Address - Fax:
Practice Address - Street 1:608 N MADISON AVE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3100
Practice Address - Country:US
Practice Address - Phone:919-330-4802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health