Provider Demographics
NPI:1295076859
Name:SCHIPPERS, CRYSTAL SUE
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:SUE
Last Name:SCHIPPERS
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 1:813 W SOUTH ST
Mailing Address - Street 2:UPPER LEVEL
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-4696
Mailing Address - Country:US
Mailing Address - Phone:269-870-6915
Mailing Address - Fax:
Practice Address - Street 1:813 W SOUTH ST
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007
Practice Address - Country:US
Practice Address - Phone:269-870-6915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist