Provider Demographics
NPI:1588451991
Name:DREWRY, CRYSTAL GAYLE (LPN)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:GAYLE
Last Name:DREWRY
Suffix:
Gender:
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:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:MANGHAM
Mailing Address - State:LA
Mailing Address - Zip Code:71259-0002
Mailing Address - Country:US
Mailing Address - Phone:318-237-7334
Mailing Address - Fax:
Practice Address - Street 1:2390 HIGHWAY 15
Practice Address - Street 2:
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-5782
Practice Address - Country:US
Practice Address - Phone:318-237-7334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2705263747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider