Provider Demographics
NPI:1730777160
Name:FOSTER JONES, CRYSTAL MICHELLE
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:MICHELLE
Last Name:FOSTER JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 GREY FLATS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-5874
Mailing Address - Country:US
Mailing Address - Phone:304-255-7676
Mailing Address - Fax:304-929-6007
Practice Address - Street 1:201 GREY FLATS RD STE 200
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-5874
Practice Address - Country:US
Practice Address - Phone:304-255-7676
Practice Address - Fax:304-929-6007
Is Sole Proprietor?:No
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator