MRS. CRYSTAL ADEL HONOLD (NPI# 1609171206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609171206 |
| Entity Type | Individual |
| Full Name | MRS. CRYSTAL ADEL HONOLD |
| Credential | RN, MSN, CNRN, CNS |
| Practice Address |
305 W Jackson St Ste 103 Carbondale IL 62901-1474 |
| Mailing Address |
Po Box 3988 Carbondale IL 62902-3988 |
| Practice Telephone | 6183514972 |
| Practice Fax Number | 6183516522 |
| Mailing Telephone | 6184575200 |
| Mailing Fax Number | 6185290568 |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2020-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364S00000X | Clinical Nurse Specialist | 209.008569 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
305 W JACKSON ST STE 103 |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871542811 | Michael Anthony Bryant | Physician Assistant | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2006-05-08 |
| 1427609775 | Brandi Anderson | Nurse Practitioner | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2019-09-26 |
| 1689180978 | Hope Elizabeth Merkley | Nurse Practitioner | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2017-12-21 |
| 1932578895 | Cori Starkweather | Nurse Practitioner | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2015-09-22 |
| 1326423823 | Muhammad Amjad Hameed | Psychiatry & Neurology | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2015-07-25 |
| 1972914869 | Sahil Gupta | Psychiatry & Neurology | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2014-05-13 |
| 1265698260 | Gerson A Criste | Anesthesiology | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2008-07-30 |
| 1619186269 | Tiffany Ward | Psychiatry & Neurology | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2007-05-21 |
| 1508807181 | Mark Fleming | Neurological Surgery | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2006-06-08 |
| 1376597815 | Ahmed H Jafri | Psychiatry & Neurology | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2006-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 364S00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |
| Notes: Sources: American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue and The Interagency Conference on Nursing Statistics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932728169 | Amy Lynn Katsikas | Clinical Nurse Specialist | 1405 North Green Mount Road, Suite 511, O'fallon, IL 62269-3494 | 2020-04-08 |
| 1407349343 | Tina Marie Bauman | Clinical Nurse Specialist | 1555 Barrington Rd Ste 1400, Hoffman Estates, IL 60169-5038 | 2018-06-13 |
| 1639547417 | Virginia Ann Baker | Clinical Nurse Specialist | 5758 S Maryland Ave # Mc9024, Chicago, IL 60637-1426 | 2015-09-09 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1821474388 | Deborah Ann Lawrence | Clinical Nurse Specialist | 17800 Kedzie Ave Fl 4, Hazel Crest, IL 60429-2029 | 2015-08-07 |
| 1245615947 | Gabriel Oluwakotanmi | Clinical Nurse Specialist | 8056 S Harper Ave, Chicago, IL 60619-4637 | 2015-07-23 |
| 1013398718 | Associated Physicians Group Ltd | Clinical Nurse Specialist | 4414 W Center Dr, Alton, IL 62002-5932 | 2015-06-18 |
| 1396148391 | Elizabeth Moon | Clinical Nurse Specialist | 252 Thrush Cir, Lindenhurst, IL 60046-7948 | 2014-10-03 |
| 1831435189 | Rena Thompson | Clinical Nurse Specialist | 7537 N Bell Ave, Suite 1, Chicago, IL 60645-2484 | 2012-12-13 |
| 1144564188 | Melanie Ann Reeves | Clinical Nurse Specialist | 530 Ne Glen Oak Ave Po Box G13, Peoria, IL 61637-0001 | 2012-11-15 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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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.