Provider Demographics
NPI:1447965603
Name:PAZDER, CRYSTAL (PA)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:PAZDER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:
Other - Last Name:TRUCKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 LONG LEAF LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35022-4345
Mailing Address - Country:US
Mailing Address - Phone:706-619-8659
Mailing Address - Fax:
Practice Address - Street 1:1802 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1932
Practice Address - Country:US
Practice Address - Phone:205-996-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical