Ellis, Krystal Lynn

Ellis, Krystal Lynn is an individual health care provider with primary practice located at 6096 W Park Ave , Houma LA 70364-1808. She recently has only one registered license in Pharmacy Service Providers / Pharmacy Technician, which is considered as her primary health care specialty. Ellis, Krystal Lynn can be contacted via phone (985) 876-2584.

Contact Information

Primary practice address
6096 W Park Ave Houma LA 70364-1808
Phone: (985) 876-2584
Fax: (985) 876-5050
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacy Technician 183700000X 6462 Louisiana

Profile Details

NPI number 1124596630
LBN Legal business name Ellis, Krystal Lynn
Credentials CPHT
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2018
Last updated Nov 2nd, 2018 - about 7 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 1124596630 NPPES
Louisiana Other 6462PT BOARD OF PHARMACY LIC# 6462PT

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