CAROL D CRISP PHD MSN FNP-BC NPI 1689730616

NPI Information

NPI: 1689730616
Provider Name: CAROL D CRISP, PHD, MSN, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
3312 GATEWAY ST
SPRINGFIELD, OR
ZIP 97477
Phone: (541) 204-4745
Get Directions

Carol D Crisp, PHD, MSN, FNP-BC is a family nurse practitioner in Springfield, OR with 18 years of experience. Carol D Crisp, PHD, MSN, FNP-BC NPI is 1689730616. 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:

3312 GATEWAY ST
SPRINGFIELD, OR
ZIP 97477-054
Phone: (541) 204-4745

The NPI 1689730616 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 12/27/2006 and was last updated on 7/27/2023.

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	363LF0000X	Nurse Practitioner	Family	CNP61599	IDAHO	No
2	363LF0000X	Nurse Practitioner	Family	10002835	OREGON	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	10002835	OTHER	OREGON	STATE LICENSE
2	CNP61599	OTHER	IDAHO	STATE LICENSE

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: 4/28/2024

NPI Synchronization or Removal

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