Provider Demographics
NPI:1902643760
Name:HISER, CRYSTAL T
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:T
Last Name:HISER
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 1:257 HIGH ST E
Mailing Address - Street 2:
Mailing Address - City:OSTRANDER
Mailing Address - State:OH
Mailing Address - Zip Code:43061-9401
Mailing Address - Country:US
Mailing Address - Phone:740-513-0755
Mailing Address - Fax:
Practice Address - Street 1:257 HIGH ST E
Practice Address - Street 2:
Practice Address - City:OSTRANDER
Practice Address - State:OH
Practice Address - Zip Code:43061-9401
Practice Address - Country:US
Practice Address - Phone:740-513-0755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No251E00000XAgenciesHome Health