Dillett, Crystal J

Dillett, Crystal J is an individual health care provider with primary practice located at 146 E Geneva Sq , Lake Geneva WI 53147-9694. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Dillett, Crystal J can be contacted via phone (262) 939-5459.

Contact Information

Primary practice address
146 E Geneva Sq Lake Geneva WI 53147-9694
Phone: (262) 939-5459
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 6443 Wisconsin

Profile Details

NPI number 1033593918
LBN Legal business name Dillett, Crystal J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2015
Last updated Dec 1st, 2021 - about 3 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 1033593918 NPPES
Wisconsin MEDICAID 100047118

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