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
Phone: (304) 265-4909
Fax: (304) 265-4915
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699873257 | NPPES |
| West Virginia | MEDICAID | 3910005605 |
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