Provider Demographics
NPI:1528330032
Name:NUNLEY, CRYSTAL LUCIA (LPN)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:LUCIA
Last Name:NUNLEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8656 FLOWER PATH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-1800
Mailing Address - Country:US
Mailing Address - Phone:281-458-0616
Mailing Address - Fax:
Practice Address - Street 1:8656 FLOWER PATH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-1800
Practice Address - Country:US
Practice Address - Phone:281-458-0616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14083164W00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No372600000XNursing Service Related ProvidersAdult Companion