Provider Demographics
NPI:1144006750
Name:BRANCH, CRYSTAL C (APRN)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:C
Last Name:BRANCH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:CRYSTAL
Other - Middle Name:C
Other - Last Name:MARTENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:8801 LAZY RIVER DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-6983
Mailing Address - Country:US
Mailing Address - Phone:423-667-3366
Mailing Address - Fax:
Practice Address - Street 1:8801 LAZY RIVER DR
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:TN
Practice Address - Zip Code:37341-6983
Practice Address - Country:US
Practice Address - Phone:423-667-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000034334363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily