Crumbliss, Christina Grace

Crumbliss, Christina Grace is an individual health care provider with primary practice located at 7220 W National Ave , West Allis WI 53214-4734. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Crumbliss, Christina Grace can be contacted via phone (414) 257-8550.

Contact Information

Primary practice address
7220 W National Ave West Allis WI 53214-4734
Phone: (414) 257-8550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X LL 34569 South Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 63914-20 Wisconsin

Profile Details

NPI number 1790047900
LBN Legal business name Crumbliss, Christina Grace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2012
Last updated Aug 1st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790047900 NPPES
Wisconsin MEDICAID 100046480

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