Provider Demographics
NPI:1356761498
Name:CRISPI, MARCI LEIGH (FNP-C)
Entity type:Individual
Prefix:
First Name:MARCI
Middle Name:LEIGH
Last Name:CRISPI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MARCI
Other - Middle Name:LEIGH
Other - Last Name:THAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:133 S 500 E
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2728
Mailing Address - Country:US
Mailing Address - Phone:435-247-1184
Mailing Address - Fax:435-781-0536
Practice Address - Street 1:1525 W 2100 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-1407
Practice Address - Country:US
Practice Address - Phone:801-213-9910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2022-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7714660-3102163W00000X, 163WG0000X
UT7714660-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice