Provider Demographics
NPI:1306951983
Name:HEIGHT, CRYSTAL MICHELLE (APRN-BC, NP, BCBA)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:MICHELLE
Last Name:HEIGHT
Suffix:
Gender:F
Credentials:APRN-BC, NP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 W 47TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-1772
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:702 W 47TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-1772
Practice Address - Country:US
Practice Address - Phone:912-507-1553
Practice Address - Fax:912-443-9004
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2009-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN 141187 NP363LA2200X
1-09-5068103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q70158Medicare UPIN