Provider Demographics
NPI:1295743466
Name:CRISSMAN, BLYTHE GREENE (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:BLYTHE
Middle Name:GREENE
Last Name:CRISSMAN
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DUKE UNIVERSITY MEDICAL CTR
Mailing Address - Street 2:BOX 3528
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-681-1976
Mailing Address - Fax:919-668-0414
Practice Address - Street 1:DUKE UNIVERSITY MEDICAL CTR
Practice Address - Street 2:BOX 3528
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-681-1976
Practice Address - Fax:919-668-0414
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS