MR. JACK PHIL KRYSTYN JR. (NPI# 1720161607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720161607 |
| Entity Type | Individual |
| Full Name | MR. JACK PHIL KRYSTYN JR. |
| Credential | RN |
| Practice Address |
184 Caravan Ln Kinsey AL 36303-7694 |
| Practice Telephone | 3346788268 |
| Mailing Telephone | 3346788268 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WE0003X |
Registered Nurse Specialization: Emergency |
1-03341 | AL | Nursing Service Providers |
| Street Address |
184 CARAVAN LN |
| City | KINSEY |
| State | AL |
| Zip Code | 36303-7694 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194205740 | Emblom & Vaughn, D.m.d., PC | Dentist | 318 Healthwest Dr., Dothan, AL 36303 | 2018-08-14 |
| 1164887907 | Bio-medical Applications of Alabama, Inc. | Clinic/Center | 118 Obrannan Park Drive, Dothan, AL 36303 | 2015-12-21 |
| 1245634245 | Api Counseling, LLC | Community/Behavioral Health | 1583 Montgomery Highway, Dothan, AL 36303 | 2014-10-20 |
| 1467792382 | Bolanle Boladale Akinduro | Home Health | 107 Hidden Glen Way, Dothan, AL 36303 | 2013-03-01 |
| 1104162114 | Al Dental PC | Dentist | 3400 Montgomery Highway, Dothan, AL 36303 | 2012-12-19 |
| 1659661874 | Juanita Titrud Heersink | Internal Medicine | 210 Westside Drive, Dothan, AL 36303 | 2011-04-08 |
| 1790918548 | Brandi Bradshaw Reeves | Counselor | 100 Westside Dr., Dothan, AK 36303 | 2009-08-27 |
| 1396917589 | Brian Davis | Physical Therapist | 3763 Ross Clark Circle, Dothan, AL 36303 | 2008-03-27 |
| 1558544544 | Healthwest Dental Associates PC | Dentist | 502 Healthwest Drive, Dothan, AL 36303 | 2007-12-12 |
| 1770644775 | Christine Carroll Fain | Occupational Therapist | 3763 Ross Clark Cir Ste 1, Alacare Home Health, Dothan, AL 36303 | 2006-12-13 |
| Find all providers in zip 36303 | ||||
| Taxonomy Code | 163WE0003X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Emergency |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667748 | Lyric Logan | Registered Nurse | 2522 Bear Creek Cove Ln, Duncanville, AL 35456-2942 | 2020-10-19 |
| 1548809916 | Claudine Williamson | Registered Nurse | 1503 Pettibone Rd, Greenville, AL 36037-7161 | 2020-01-02 |
| 1295371375 | Brittany Mcevoy | Registered Nurse | 1477 Taylors Chapel Road, Oxford, AL 36203 | 2019-11-22 |
| 1700436920 | Penny Burcham | Registered Nurse | 285 Coweta Trl, Oxford, AL 36203-0298 | 2019-09-19 |
| 1043661747 | Cynthia Jenkins | Registered Nurse | 249 Marelyn Ln, Odenville, AL 35120-6752 | 2016-06-24 |
| 1013372796 | Paula Denise King | Registered Nurse | 1045 Jim Thomas Rd, Hayden, AL 35079-4447 | 2015-12-22 |
| 1386013456 | Margaret Gendron | Registered Nurse | 12841 Hunters Chase, Foley, AL 36535-8589 | 2015-09-18 |
| 1710260542 | Robert W Hill | Registered Nurse | 2825 N 19th St, Hueytown, AL 35023 | 2011-09-28 |
| 1932379401 | Tina Fulford | Registered Nurse | 212 Ramsey Dr, Selma, AL 36701-7145 | 2008-03-11 |
| 1649449026 | Robert Joseph Lister | Registered Nurse | 7651 Cameron Ct, Mobile, AL 36695-4463 | 2008-02-29 |
| Find all providers with the same taxonomy | ||||
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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.