Provider Demographics
NPI:1710400304
Name:ZIEGLER, CRYSTAL ANN (CRNP)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ANN
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 INDUSTRIAL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1605
Mailing Address - Country:US
Mailing Address - Phone:610-644-3166
Mailing Address - Fax:610-644-3162
Practice Address - Street 1:4 INDUSTRIAL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1605
Practice Address - Country:US
Practice Address - Phone:610-644-3166
Practice Address - Fax:610-644-3162
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily