Provider Demographics
NPI:1255961751
Name:LAMB, KRYSTAL LYNN (NP)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:LYNN
Last Name:LAMB
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 COSBY HWY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-3455
Mailing Address - Country:US
Mailing Address - Phone:423-237-6546
Mailing Address - Fax:423-237-6579
Practice Address - Street 1:756 COSBY HWY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-3455
Practice Address - Country:US
Practice Address - Phone:423-237-6546
Practice Address - Fax:423-237-6579
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27060363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily