RICHARD CRISOSTOMO (NPI# 1245753656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245753656 |
| Entity Type | Individual |
| Full Name | RICHARD CRISOSTOMO |
| Credential | PMHNP-BC |
| Practice Address |
3505 E Meridian Park Loop Ste 200 Wasilla AK 99654-7242 |
| Practice Telephone | 0793574400 |
| Practice Fax Number | 9073574410 |
| Mailing Telephone | 0793574400 |
| Mailing Fax Number | 0793574410 |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2020-01-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
132337 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APRN002619 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
TAPRN701646 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1265 S Seward Meridian Pkwy, Wasilla, AK 996548351 | 9073769091 | 9073769094 |
| 745 W Moana Ln Ste 100, Reno, NV 895094940 | 7753343033 |
| Street Address |
3505 E MERIDIAN PARK LOOP STE 200 |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-7242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457859902 | Nicole Gregson | Counselor | 3505 E Meridian Park Loop Ste 200, Wasilla, AK 99654-7294 | 2018-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316597412 | Jennifer Byers Anp LLC | Nurse Practitioner | 1689 S Knik Goose Bay Rd Ste 700, Wasilla, AK 99654-8088 | 2019-09-19 |
| 1922553726 | Adriana Maria Hernandez | Nurse Practitioner | 2405 S Knik Goose Bay Rd, Ste A, Wasilla, AK 99654-9965 | 2016-08-22 |
| 1437318383 | Lynda Selk | Nurse Practitioner | 15089 W Big Lake Lodge Rd, Wasilla, AK 99623-4819 | 2008-06-05 |
| 1518514652 | Erin Rockey, Anp LLC | Nurse Practitioner | 491 N Knik St, Wasilla, AK 99654-7049 | 2019-08-22 |
| 1871724773 | Christi Hill, Anp Family Psychiatry LLC | Nurse Practitioner | 851 E Westpoint Dr, Ste. 208, Wasilla, AK 99654-7191 | 2009-07-27 |
| 1538359310 | Heather Brock, Inc | Nurse Practitioner | 851 E Westpoint Dr, Ste 208, Wasilla, AK 99654-7142 | 2007-07-27 |
| 1609949817 | Jill Kristine Dowell | Nurse Practitioner | 1363 W Spruce Ave, Wasilla, AK 99654-5327 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366062903 | Eagle River Behavioral Health, LLC | Nurse Practitioner | 13125 Curry Ridge Cir, Eagle River, AK 99577-6730 | 2020-04-23 |
| 1760017123 | Sara Rottman | Nurse Practitioner | 2210 Sentry Dr Apt 14, Anchorage, AK 99507-5353 | 2020-03-05 |
| 1104464460 | David Ampong | Nurse Practitioner | 1577 C St Ste 204, Anchorage, AK 99501-5164 | 2019-12-18 |
| 1538720404 | Deanna Mae Casiano | Nurse Practitioner | 14460 E Pace Dr, Palmer, AK 99645-9964 | 2019-06-21 |
| 1154897429 | Kristerra Nicole Yawea | Nurse Practitioner | 2440 E Tudor Rd # 384, Anchorage, AK 99507-1185 | 2018-10-15 |
| 1982187399 | Sara A Lindsoe | Nurse Practitioner | 8136 White Dr, Anchorage, AK 99507-6046 | 2018-09-11 |
| 1609326594 | Virginia Walker | Nurse Practitioner | 3211 Providence Drive Rh Ste 116, University of Alaska Anchorage Student Health & Councel, Anchorage, AK 99508 | 2016-10-04 |
| 1649622457 | Jenifer Swigart | Nurse Practitioner | 915 W. Northern Lights Blvd, Anchorage, AK 99503 | 2016-07-05 |
| 1124370523 | Donna Jean Rollins | Nurse Practitioner | 4251 Bartlett St, Homer, AK 99603-7006 | 2012-10-09 |
| 1649591504 | Karen E Sasnett | Nurse Practitioner | 4321 Gannett Cir, Anchorage, AK 99504-4203 | 2010-06-15 |
| 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.