Provider Demographics
NPI:1023444882
Name:CROSBY, CHRSTINA NICHOLE (RN)
Entity type:Individual
Prefix:
First Name:CHRSTINA
Middle Name:NICHOLE
Last Name:CROSBY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-4984
Mailing Address - Country:US
Mailing Address - Phone:843-782-4516
Mailing Address - Fax:843-549-6220
Practice Address - Street 1:256 SMITH ST
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-4984
Practice Address - Country:US
Practice Address - Phone:843-782-4516
Practice Address - Fax:843-549-6220
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC204408163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse