Provider Demographics
NPI:1194508788
Name:HIPKINS, CRYSTAL LYNNE (QMHP)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:LYNNE
Last Name:HIPKINS
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:MISS
Other - First Name:CRYSTAL
Other - Middle Name:LYNNE
Other - Last Name:BERNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:429 MEADOWBROOK SHOPPING CTR # 1003
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3980
Mailing Address - Country:US
Mailing Address - Phone:540-409-4686
Mailing Address - Fax:
Practice Address - Street 1:KOREA INTERNATIONAL SCHOOL, JEJU CAMPUS
Practice Address - Street 2:34 GLOBAL EDU-RO, 260 BEON-GIL, DAEJEONG-EUP
Practice Address - City:SEOGWIPO-SI
Practice Address - State:JEJU
Practice Address - Zip Code:20 63644
Practice Address - Country:KR
Practice Address - Phone:540-409-4686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0734007048OtherCOMMONWEALTH OF VIRGINIA