Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Crystal Dale Grantham

Individual provider Family Nurse Practitioner · NPI 1336633791

Crystal Dale Grantham is a Nurse Practitioner in Richton, Mississippi. Qualified in 2018, 8 years ago. Practices with Field Memorial Community Hospital, a 40-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
8
Licensed in
MS
In the registry since
2018

Practice location Address checks out

210 Bay Ave
Richton, MS 39476-9665
Phone: (601) 788-9222
Fax: (601) 788-6318
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 178 Highway 24 E, Centreville, MS 39631-4171 — (601) 890-0500

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 902689 (MS)

Record details

NPI number1336633791
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 19, 2018
Last updated in NPPESJune 12, 2026
Certification dateJune 12, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Field Memorial Community Hospital — 40 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Richton