Provider Demographics
NPI:1912171976
Name:TAYLOR, CRYSTAL L'TARA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:L'TARA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 W MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5527
Mailing Address - Country:US
Mailing Address - Phone:501-664-6017
Mailing Address - Fax:501-664-6074
Practice Address - Street 1:3901 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5527
Practice Address - Country:US
Practice Address - Phone:501-664-6017
Practice Address - Fax:501-664-6074
Is Sole Proprietor?:No
Enumeration Date:2008-04-21
Last Update Date:2011-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist