Provider Demographics
NPI:1497963607
Name:CROSSLIN, GINA ROCHELLE (RT(T))
Entity type:Individual
Prefix:MISS
First Name:GINA
Middle Name:ROCHELLE
Last Name:CROSSLIN
Suffix:
Gender:F
Credentials:RT(T)
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2814 REDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79107-2043
Mailing Address - Country:US
Mailing Address - Phone:806-381-9270
Mailing Address - Fax:
Practice Address - Street 1:1005 E 23RD ST STE 200
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-0800
Practice Address - Country:US
Practice Address - Phone:866-784-2329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX917042471R0002X
SC00-54162471R0002X
CARHT 887182471R0002X
MERT400046812471R0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy