person
Crystal Dale Grantham
Family Nurse Practitioner in Richton, Mississippi
NPI 1336633791

Crystal Dale Grantham is a Family Nurse Practitioner based in Richton, MS and is specialized in Family. Crystal Dale Grantham practices in Richton, MS. The NPI Number for Crystal Dale Grantham is 1336633791 and holds a License No. 902689 (Mississippi).

The current practice location address for Crystal Dale Grantham is 210 Bay Ave, Richton, MS and can be reached out via phone at 601-788-9222 and via fax at 601-788-6318.

Location: 210 Bay Ave, Richton, MS, 39476-9665
person
Provider Profile Details
NPI Number
1336633791
Provider Name
Crystal Dale Grantham
Credential
Provider Entity Type
Individual
Gender
Female
Address
210 Bay Ave, Richton, MS, 39476-9665
Phone Number
601-788-9222
Fax Number
601-788-6318
Provider Enumeration Date
06/19/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
210 Bay Ave
City
State
Zip
39476-9665
Phone Number
601-788-9222
Fax Number
601-788-6318
person
Provider Business Mailing Address Details
Address
210 Bay Ave
City
State
Zip
39476-9665
Phone Number
601-788-9222
Fax Number
601-788-6318
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
902689 (Mississippi)
Definition
Definition to come...
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