Provider Demographics
NPI:1053118349
Name:JING, CRYSTAL Y (BA)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:Y
Last Name:JING
Suffix:
Gender:
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E PETTIGREW ST APT 239
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-4869
Mailing Address - Country:US
Mailing Address - Phone:608-886-6251
Mailing Address - Fax:
Practice Address - Street 1:510 E PETTIGREW ST APT 239
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-4869
Practice Address - Country:US
Practice Address - Phone:608-886-6251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program