Provider Demographics
NPI:1255885604
Name:LOGSDON, CRYSTAL L (ARNP)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:L
Last Name:LOGSDON
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 INDUSTRIAL BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-7668
Mailing Address - Country:US
Mailing Address - Phone:850-290-8410
Mailing Address - Fax:866-574-6391
Practice Address - Street 1:45 INDUSTRIAL BLVD STE C
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-7668
Practice Address - Country:US
Practice Address - Phone:850-290-8410
Practice Address - Fax:866-574-6391
Is Sole Proprietor?:No
Enumeration Date:2016-08-14
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA177560363LA2100X
FLARNP9452609363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care