CRYSTAL HOPE FREDRICKSON PA NPI 1649329996

NPI Information

NPI: 1649329996
Provider Name: CRYSTAL HOPE FREDRICKSON, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: GLENN KOESTER MD PC

PECOS Registration: Yes

Address:
3863 S BOULEVARD
EDMOND, OK
ZIP 73013
Phone: (405) 216-5444
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Crystal Hope Fredrickson, PA is a medical physician assistant in Edmond, OK with 21 years of experience. Crystal Hope Fredrickson, PA NPI is 1649329996. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3863 S BOULEVARD
EDMOND, OK
ZIP 73013-540
Phone: (405) 216-5444
Fax: (405) 216-5445

The NPI 1649329996 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/9/2007 and was last updated on 7/22/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	1324	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Q11121	MEDICARE UPIN	OKLAHOMA
2	241413203	MEDICARE ID-TYPE UNSPECIFIED	OKLAHOMA	INDIVIDUAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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