Provider Demographics
NPI:1063149201
Name:BROWN, KRYSTAL C
Entity type:Individual
Prefix:MRS
First Name:KRYSTAL
Middle Name:C
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KRYSTAL
Other - Middle Name:C
Other - Last Name:MUSSELWHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 CRACKERBOX LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-5490
Mailing Address - Country:US
Mailing Address - Phone:501-525-9996
Mailing Address - Fax:501-525-2155
Practice Address - Street 1:105 CRACKERBOX LN
Practice Address - Street 2:SUITE B
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-5490
Practice Address - Country:US
Practice Address - Phone:501-525-9996
Practice Address - Fax:501-525-2155
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR691237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist