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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1324 | OK | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
3863 S BOULEVARD |
City | EDMOND |
State | OK |
Zip Code | 73013-5540 |
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 |
Find all providers in zip 73013 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
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 |
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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.