Doctor Name: | MS. LINDA L CRISWELL |
NPI Number: | 1194724146 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA9101054 |
Business Practice Address: | 39 E Atwater Ave Eustis, FL - 327265540 |
Business Phone Number: | 3524830900 |
Business Fax Number: | 3524830822 |
Mailing Address: | 39 E Atwater Ave, EUSTIS |
State: | FL |
Postal Code: | 327265540 |
Phone Number: | 3524830900 |
Fax Number: | 3524830822 |
NPI Enumeration Date: | 07/20/2005 |
NPI Last Update Date: | 10/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA9101054 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |