Provider Demographics
NPI:1083448997
Name:ALLRED, CHRYSTAL (RN)
Entity type:Individual
Prefix:
First Name:CHRYSTAL
Middle Name:
Last Name:ALLRED
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16349 S COUPLER LN
Mailing Address - Street 2:
Mailing Address - City:BLUFFDALE
Mailing Address - State:UT
Mailing Address - Zip Code:84065-1873
Mailing Address - Country:US
Mailing Address - Phone:435-650-6202
Mailing Address - Fax:
Practice Address - Street 1:16349 S COUPLER LN
Practice Address - Street 2:
Practice Address - City:BLUFFDALE
Practice Address - State:UT
Practice Address - Zip Code:84065-1873
Practice Address - Country:US
Practice Address - Phone:435-650-6202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7020850-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse