| Doctor Name: | KRYSTAL D LONGDEN |
| NPI Number: | 1548636715 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | HIS |
| License Number: | 043117357 |
| Business Practice Address: | 900 W Springfield Rd Suite 1 Taylorville, IL - 625681299 |
| Business Phone Number: | 2172871300 |
| Business Fax Number: | 2172871330 |
| Mailing Address: | 233 N Main St, Suite 3 DECATUR |
| State: | IL |
| Postal Code: | 625231208 |
| Phone Number: | 2178755555 |
| Fax Number: | 2175427490 |
| NPI Enumeration Date: | 08/11/2015 |
| NPI Last Update Date: | 08/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 164W00000X |
| License Number: | 043117357 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Licensed Practical Nurse |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |