CRYSTAL PENNELL (NPI# 1154783470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154783470 |
| Entity Type | Individual |
| Full Name | CRYSTAL PENNELL |
| Credential | CNP |
| Practice Address |
1222 10th Ave Port Huron MI 48060-3406 |
| Practice Telephone | 8109859681 |
| Practice Fax Number | 8109855310 |
| Mailing Telephone | 8109859681 |
| Mailing Fax Number | 8109855310 |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2016-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
4704239482 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1222 10TH AVE |
| City | PORT HURON |
| State | MI |
| Zip Code | 48060-3406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033198593 | Cardiology Assoc of Port Huron | Internal Medicine | 1222 10th Ave, Port Huron, MI 48060-3406 | 2006-01-12 |
| 1962069997 | Jacqueline Beauregard | Physician Assistant | 1222 10th Ave, Port Huron, MI 48060-3406 | 2019-05-24 |
| 1629549159 | Tamara Dawn Yoas | Nurse Practitioner | 1222 10th Ave, Port Huron, MI 48060-3406 | 2018-12-10 |
| 1245733955 | Caitlin Smith | Nurse Practitioner | 1222 10th Ave, Port Huron, MI 48060-3406 | 2018-03-09 |
| 1447696737 | Gabriel Crawford | Internal Medicine | 1222 10th Ave, Port Huron, MI 48060-3406 | 2013-05-14 |
| 1235332917 | Elias Skaf | Internal Medicine | 1222 10th Ave, Port Huron, MI 48060-3406 | 2007-06-08 |
| 1679534135 | Beeravolu Ramesh Reddy | Internal Medicine | 1222 10th Ave, Port Huron, MI 48060-3406 | 2006-03-31 |
| 1275594731 | Madhusudhan C Reddy | Internal Medicine | 1222 10th Ave, Port Huron, MI 48060-3406 | 2006-03-31 |
| 1760443238 | Vrajmohan C Parikh | Internal Medicine | 1222 10th Ave, Port Huron, MI 48060-3406 | 2006-03-31 |
| 1104887926 | Virender D Parekh | Internal Medicine | 1222 10th Ave, Port Huron, MI 48060-3406 | 2006-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897297 | Casey Edward Bicker | Behavior Technician | 3245 Keewahdin Rd; Fort Gratiot, Mi 48059, Port Huron, MI 48060 | 2020-09-29 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
| 1982123006 | Kenneth Shine Heuvelman | Counselor | 3522 Holland Park Ln, Port Huron, MI 48060 | 2017-09-11 |
| 1346767506 | Kelly Baker | Social Worker | 520 Superior St., Port Huron, MI 48060 | 2017-08-28 |
| 1326418609 | Jean Burleigh | Chore Provider | 614 Staton, Port Huron, MI 48060 | 2015-09-30 |
| 1205242161 | Lisa Gray | Counselor | 2885 W Rick Dr, Port Huron, MI 48060 | 2014-07-10 |
| 1861758880 | Aaron Overly | Surgery | 2609 Electric Ave Ste B&, Port Huron, MI 48060 | 2012-04-03 |
| 1942591508 | S Akram Ali | Surgery | 3270 Waldheim Dr, Port Huron, MI 48060 | 2011-04-29 |
| 1417258179 | Nicholas Alexander Tobianski | Physician Assistant | 3550 Pine Grove Avenue, Port Huron, MI 48060 | 2010-11-11 |
| 1598092769 | Blue Water Pharmacy LLC | Pharmacy | 1524 10th Street, Port Huron, MI 48060 | 2009-11-10 |
| Find all providers in zip 48060 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245733955 | Caitlin Smith | Nurse Practitioner | 1222 10th Ave, Port Huron, MI 48060-3406 | 2018-03-09 |
| 1053689695 | Elizabeth May Helmreich | Nurse Practitioner | 1201 Stone St, Suite 5, Port Huron, MI 48060-3563 | 2011-12-11 |
| 1902121965 | Patricia Elizabeth Strieter | Nurse Practitioner | 3415 28th St, Port Huron, MI 48060-6931 | 2010-04-02 |
| 1164483707 | Jody A Britz | Nurse Practitioner | 1231 Pine Grove Ave, Suite 2b, Port Huron, MI 48060-3500 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275130619 | Mohammad Afzal Khan | Nurse Practitioner | 29147 Appleblossom Ln, Farmington Hills, MI 48331-2420 | 2020-10-08 |
| 1528679305 | Eriko Apriliando | Nurse Practitioner | 15300 Silver Pkwy Apt 208, Fenton, MI 48430-3479 | 2020-08-13 |
| 1245858307 | Katherine Perko Hollander | Nurse Practitioner | 2274 Earlmont Rd, Berkley, MI 48072-1877 | 2020-07-06 |
| 1437782067 | Jamie Lynn Kosalsky | Nurse Practitioner | 1385 Cadmus Dr, Troy, MI 48085-1218 | 2020-02-21 |
| 1326698309 | Maria Christina Mekas | Nurse Practitioner | 423 Tamarack Dr, Saline, MI 48176-9573 | 2019-09-12 |
| 1669021358 | Cheryl Fowler | Nurse Practitioner | 523 Fontenelle St Se, Grand Rapids, MI 49548-7316 | 2019-09-05 |
| 1205482387 | Sarah E Born | Nurse Practitioner | 517 Erie Street, Three Rivers, MI 49093-2029 | 2019-08-14 |
| 1023660321 | Cheri Van Wyngarden | Nurse Practitioner | 6250 Jupiter Ave Ne, Belmont, MI 49306-8711 | 2019-07-16 |
| 1194385500 | Adesuwa Iyoha | Nurse Practitioner | 30509 Halecreek St, Romulus, MI 48174-3224 | 2019-06-18 |
| 1740740190 | John Kenneth Dekock | Nurse Practitioner | 5327 48th Ave, Hudsonville, MI 49426-9412 | 2019-03-21 |
| Find all providers with the same taxonomy | ||||
| City | PORT HURON |
| Zip Code | 48060 |
Please comment or provide details below to improve the information on CRYSTAL PENNELL.
| 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.