Rucker, Crystal D

Rucker, Crystal D is an sole proprietor health care provider with primary practice located at 725 N Pike St , Grafton WV 26354-1270. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Rucker, Crystal D can be contacted via phone (304) 265-4909.

Contact Information

Primary practice address
725 N Pike St Grafton WV 26354-1270
Fax: (304) 265-4915
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 461 West Virginia

Profile Details

NPI number 1699873257
LBN Legal business name Rucker, Crystal D
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2006
Last updated Feb 25th, 2019 - 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 1699873257 NPPES
West Virginia MEDICAID 3910005605

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