Provider Demographics
NPI:1316428329
Name:ABLE, CRYSTAL ANN
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ANN
Last Name:ABLE
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 1:3262 MEADOWDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-6354
Mailing Address - Country:US
Mailing Address - Phone:804-298-0897
Mailing Address - Fax:
Practice Address - Street 1:502 CLAUSON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1204
Practice Address - Country:US
Practice Address - Phone:804-266-5271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide