Provider Demographics
NPI:1306233028
Name:WRIGHT, CRYSTAL LYNN
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:LYNN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3888 ELFSTONE LANE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1136
Mailing Address - Country:US
Mailing Address - Phone:804-868-8155
Mailing Address - Fax:
Practice Address - Street 1:3888 ELFSTONE LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-1136
Practice Address - Country:US
Practice Address - Phone:804-868-8155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program