KRYSTLE PENN (NPI# 1154877363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154877363 |
| Entity Type | Individual |
| Full Name | KRYSTLE PENN |
| Practice Address |
290 Highway 314 Suite B Fayetteville GA 30214-7813 |
| Practice Telephone | 4049947727 |
| Mailing Telephone | 4049947727 |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-09-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
290 HIGHWAY 314 SUITE B |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-7813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841269768 | Olistell, Inc. | Home Health | 290 Highway 314, Suite C, Fayetteville, GA 30214-7813 | 2006-03-14 |
| 1851740948 | Lakeisha Joseph | Speech-Language Pathologist | 290 Highway 314, Suite B, Fayetteville, GA 30214-7813 | 2016-06-08 |
| 1467808246 | Phedra Fields | Occupational Therapist | 290 Highway 314, Suite B, Fayetteville, GA 30214-7813 | 2016-05-10 |
| 1447623756 | Shamiqua Johnson | Speech-Language Pathologist | 290 Highway 314, Suite B, Fayetteville, GA 30214-7813 | 2015-11-09 |
| 1114205895 | Andrea J Adams | Counselor | 290 Highway 314, Suite D, Fayetteville, GA 30214-7813 | 2011-07-28 |
| 1669750345 | Serenity Counseling & Consulting Services | Counselor | 290 Highway 314, Suite D, Fayetteville, GA 30214-7813 | 2011-07-28 |
| 1558508580 | Ideal Therapy, LLC | Physical Therapist | 290 Highway 314, Suite B, Fayetteville, GA 30214-7813 | 2009-01-13 |
| 1013000900 | Laura Marie Carn Smith | Dentist | 290 Highway 314, Suite A, Fayetteville, GA 30214-7813 | 2006-10-02 |
| 1447341359 | Clarence A Parrott | Dentist | 290 Highway 314, Suite A, Fayetteville, GA 30214-7813 | 2006-09-27 |
| 1871698134 | Stacy G Smith | Dentist | 290 Highway 314, Suite A, Fayetteville, GA 30214-7813 | 2006-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356948855 | Danielle Kringlie | Massage Therapist | 921 Old Hunt Pl, Fayetteville, NC 28314-6073 | 2020-10-07 |
| 1871100222 | Christopher Calvin | Massage Therapist | 147 Banks Sta, Fayetteville, GA 30214-7504 | 2020-09-29 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1013529957 | Sonja Renee Gibson | Massage Therapist | 275 Glynn St S, Fayetteville, GA 30214-2015 | 2020-08-21 |
| 1194337345 | Natalie Spencer | Massage Therapist | 3037 Boone Trail Ext Ste G, Fayetteville, NC 28304-3859 | 2020-08-19 |
| 1528677812 | Lamonica Laveta Greene | Massage Therapist | 7804 Loxley Drive, Fayetteville, NC 28314 | 2020-07-23 |
| 1942834007 | Reds of Fayetteville, LLC | Massage Therapist | 1534 Purdue Dr, Fayetteville, NC 28303-5416 | 2020-02-27 |
| 1225662430 | Tracy Renfro | Massage Therapist | 3015 Kingfisher Dr, Fayetteville, NC 28306-9189 | 2020-02-26 |
| 1568011120 | Lacana N Tenn | Massage Therapist | 106 New Hope Rd, Fayetteville, GA 30214-1360 | 2019-09-06 |
| 1114589645 | Prima Elements, LLC | Massage Therapist | 124 Anderson St, Fayetteville, NC 28301-5014 | 2019-07-04 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on KRYSTLE PENN.
| 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.