Individual provider · Type 1 NPI

Crystal Lyne Carradine, DO

Military Health Care Provider · Portsmouth, VA

NPI number 1659016186 Active

Practice location

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Mailing address

6341 Klines Dr
Girard, OH 44420-1260

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Military Health Care Provider Primary 171000000XNone listed

Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

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About NPI 1659016186

Crystal Lyne Carradine, DO's National Provider Identifier is 1659016186, issued on Apr 29, 2022. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Portsmouth, VA. The record was last updated on Dec 15, 2022.