Most Relevant Information
Provider Data
| NPI Number: | 1003696196 |
| Provider Name: | CRYSTAL DAWN VANCE |
| Entity Type: | Individual |
| Taxonomy Code: | 163WS0200X |
| Specialty: | Registered Nurse |
| License Number: | R858710 |
Most Important Dates
| Enumeration Date: | 10/05/2023 |
| Last Updated: | 10/05/2023 |
Provider Practice Location
636 STARKVILLE RD
HOUSTON
MS
388519303
Practice Location Phone/Fax
| Phone: | 6625429065 |
| Fax: |
Provider Mailing Location
636 STARKVILLE RD
HOUSTON
MS
388519303
Provider Mailing Phone/Fax
| Phone: | 6625429065 |
| Fax: |