Basic Information
| Provider Information | |||||||||
| NPI: | 1912480039 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRABEL | ||||||||
| FirstName: | CRYSTAL | ||||||||
| MiddleName: | M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 208 COLUMBUS ST | ||||||||
| Address2: | |||||||||
| City: | HICKSVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435261299 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195426692 | ||||||||
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| Practice Location | |||||||||
| Address1: | 208 COLUMBUS ST | ||||||||
| Address2: | |||||||||
| City: | HICKSVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435261299 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195426692 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2018 | ||||||||
| LastUpdateDate: | 09/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 71008632A | IN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | APRN.CNP.023623 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.