CRYSTAL HOPE FREDRICKSON


Address: 3863 S Boulevard, Edmond, OK 73013-5540
Phone: 4052165444

CRYSTAL HOPE FREDRICKSON (NPI# 1649329996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649329996
Entity Type Individual
Full Name CRYSTAL HOPE FREDRICKSON
Credential PA
Practice Address 3863 S Boulevard
Edmond
OK 73013-5540
Practice Telephone 4052165444
Practice Fax Number 4052165445
Mailing Telephone 4052165444
Mailing Fax Number 4052165445
Enumeration Date 2007-01-09
Last Update Date 2013-07-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
1324 OK Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 3863 S BOULEVARD
City EDMOND
State OK
Zip Code 73013-5540

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407461866 Alison Church-pugh Case Manager/Care Coordinator 1441 Kelley Pointe Pkwy, Edmond, OK 73013 2020-09-12
1699395343 Dental Specialists of Edmond Dentist 16430 Muirfield Pl, Edmond, OK 73013 2020-04-23
1104477215 Kammerer Richey LLC Nurse Practitioner 902 Nw 139th Street Parway, Edmond, OK 73013 2019-09-20
1811459191 Peak Movement Centre, Pllc Clinic/Center 13816 Santa Fe Crossing Dr, Edmond, OK 73013 2019-04-04
1851858492 Luma Hilal Pharmacist 2228 Nw 15th Terrace, Edmond, OK 73013 2019-03-01
1578031571 Oklahoma Wellness Group LLC Internal Medicine 14101 North Esatern Avenue Suite B, Edmond, OK 73013 2018-11-07
1477034395 Specialty Care Pediatrics, Inc. Home Health 2256 Nw 164th Street, Edmond, OK 73013 2018-08-28
1972083921 Pooja Bhakta Physician Assistant Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 2018-08-20
1417460577 Oklahoma Cvs Pharmacy LLC Durable Medical Equipment & Medical Supplies 15103 N Macarthur Blvd, Oklahoma City, OK 73013 2017-11-13
1356879753 Shawn Smith Optimal Pt and Performance, Pllc Physical Therapist 336 Ne 145th Pl, Edmond, OK 73013 2017-05-30
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1568884047 Bethany J Triana Physician Assistant 3863 South Boulevard, #200, Edmond, OK 73013-5540 2014-01-17
1326312661 Stephani Lynn Jones Physician Assistant 305 S Bryant Ave, Suite 110, Edmond, OK 73034-5726 2012-03-05
1881886851 Dana S Cortez Physician Assistant 925 W I 35 Frontage Rd Ste 100, Edmond, OK 73034-7399 2007-08-14
1952404238 Jamie Shane Massengill Physician Assistant 7555 Winterwood Dr, Edmond, OK 73025-1861 2006-09-05
1508807520 Tommy Dean Camp Physician Assistant 1101 Nw 178th St, Suite B, Edmond, OK 73012-4281 2006-06-09
1700248101 Emily John Physician Assistant 1701 Renaissance Blvd, Edmond, OK 73013-3086 2016-03-24
1083072185 Rosa J. Rios Physician Assistant 4801 Integris Pkwy, Edmond, OK 73034-8864 2016-02-03
1316319817 Shelby Rae Stephens Physician Assistant 65 S Saints Blvd, Edmond, OK 73034-3051 2015-10-22
1801293105 Kelly Walker Physician Assistant 2017 W I 35 Frontage Rd, Suite 250, Edmond, OK 73013-8504 2014-12-02
1164761755 Stevie Marie White Holley Physician Assistant 46 E 15th St, Edmond, OK 73013-4301 2013-02-03
Find all providers in EDMOND

Competitor

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City EDMOND
Zip Code 73013

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Dataset Information

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.

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