CRYSTAL GAIL MANGRUM (NPI# 1518019876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518019876 |
| Entity Type | Individual |
| Full Name | CRYSTAL GAIL MANGRUM |
| Credential | C.PH.T |
| Practice Address |
111 W. Kingston Springs Rd Ste 103 Kingston Springs TN 37082 |
| Mailing Address |
Po Box 420 Bon Aqua TN 37025-0420 |
| Practice Telephone | 6159523690 |
| Practice Fax Number | 6159523692 |
| Mailing Telephone | 6154123001 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | 14104 | TN | Pharmacy Service Providers |
| Street Address |
111 W. KINGSTON SPRINGS RD STE 103 |
| City | KINGSTON SPRINGS |
| State | TN |
| Zip Code | 37082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487735585 | Marty Gentry | Pharmacist | 111 West Kingston Springs Road, Suite 103, Kingston Springs, TN 37082 | 2006-10-17 |
| 1952509572 | Columbia Medical Group - The Frist Clinic Inc | Family Medicine | 111 West Kingston Springs Road, Kingston Springs, TN 37082 | 2007-07-05 |
| 1881891927 | Christian F Vissers Md PC | Orthopaedic Surgery | 111 West Kingston Springs Road, Suite 104, Kingston Springs, TN 37082 | 2007-07-02 |
| 1508136094 | Julia Bethurum Murphy | Counselor | 1165 Bob White Rd, Kingston Springs, TN 37082-5113 | 2011-12-30 |
| 1104012426 | Jennith Brackman | Specialist | 1001 Sunset Trl, Kingston Springs, TN 37082-5239 | 2007-09-20 |
| 1215151915 | Linda Rucki | Chiropractor | 172 Luyben Hills Rd, Kingston Springs, TN 37082-8903 | 2007-04-12 |
| 1588021711 | Cynthia Borum | Nurse Practitioner | 448 Harpeth Meadows Dr, Kingston Springs, TN 37082-8919 | 2016-01-19 |
| 1346367018 | Kathryn Brooke Allen | Specialist | 396 Harpeth Meadows Dr, Kingston Springs, TN 37082-8919 | 2007-03-26 |
| 1316940893 | Jeffrey Lundy | Family Medicine | 471 Magnolia Ct, Kingston Springs, TN 37082-8931 | 2005-05-27 |
| 1184031494 | Minda Brackman | Occupational Therapist | 1070 Peery Rd, Kingston Springs, TN 37082-8950 | 2014-07-18 |
| Find all providers in zip 37082 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902425283 | Denisha N Golston | Pharmacy Technician | 1900 Belmont Blvd Apt T6, Nashville, TN 37212-3758 | 2020-04-16 |
| 1356824825 | Sharonda Bealer | Pharmacy Technician | 1661 International Place Dr Ste 150, Memphis, TN 38120-1432 | 2018-09-11 |
| 1124532478 | Vanessa Butterfly Denham | Pharmacy Technician | 5461 Blue Oak Dr, Chattanooga, TN 37416-1650 | 2017-11-24 |
| 1295121820 | Jeffrey Nicholas Williams | Pharmacy Technician | 120 Brazzell Rd, Dickson, TN 37055 | 2015-04-10 |
| 1396175907 | Niravkumar Patel | Pharmacy Technician | 7910 Regatta Dr, Apt 102, Cordova, TN 38016-1337 | 2013-11-18 |
| 1356774152 | Teri Jo Teague | Pharmacy Technician | 205 Millstone Cir, Clarksville, TN 37042-5931 | 2013-08-15 |
| 1134492713 | Sandra Denise Godsey | Pharmacy Technician | 635 Paul Huff Pkwy Nw, Cleveland, TN 37312-2970 | 2012-02-13 |
| 1316224850 | Shirley Carol Gilbert | Pharmacy Technician | 2045 Us Highway 45 Byp S, Trenton, TN 38382-2940 | 2011-11-11 |
| 1447537550 | Jason Ivory Taylor | Pharmacy Technician | 3333 E.shelby Dr., Memphis, TN 38105-4510 | 2011-11-03 |
| 1003190828 | Shantera L Childs | Pharmacy Technician | 3595 Lucy Rd, Millington, TN 38053-7807 | 2011-09-29 |
| Find all providers with the same taxonomy | ||||
| City | KINGSTON SPRINGS |
| Zip Code | 37082 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.