Walton, Crystal L

Walton, Crystal L is an individual health care provider with primary practice located at 1136 Jackson Blvd , Rapid City SD 57702-4335. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is her primary health care specialty. Walton, Crystal L can be contacted via phone (605) 721-7246.

Contact Information

Primary practice address
1136 Jackson Blvd Rapid City SD 57702-4335
Phone: (605) 721-7246
Fax: (605) 341-4501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 0539 South Dakota
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 0539 South Dakota
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0539 South Dakota

Profile Details

NPI number 1518957133
LBN Legal business name Walton, Crystal L
Credentials PA C CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Jan 10th, 2011 - about 13 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 1518957133 NPPES
South Dakota MEDICAID 1518957133
South Dakota Other 0122934
South Dakota Other 31781
South Dakota Other 41194500700
South Dakota Other 0539
South Dakota Other 4995927
South Dakota Other 119312100

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