CRYSTAL MARCUM (NPI# 1639573041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639573041 |
| Entity Type | Individual |
| Full Name | CRYSTAL MARCUM |
| Credential | APRN |
| Practice Address |
781 Grand Casino Blvd Shawnee OK 74804-1005 |
| Practice Telephone | 4059645770 |
| Practice Fax Number | 4059645788 |
| Mailing Telephone | 4059645770 |
| Mailing Fax Number | 4059645788 |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2019-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 114855 | OK | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
114855 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457965956 | Crystal Marcum | Behavior Technician | 2121 7th St, Parkersburg, WV 26101-3803 | 2020-09-02 |
| Street Address |
781 GRAND CASINO BLVD |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74804-1005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285606608 | George A Vascellaro | Family Medicine | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2006-02-02 |
| 1871100255 | Rachel Louise Clark | Licensed Practical Nurse | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2020-09-29 |
| 1518593656 | Chantel Renne Andrews | Registered Nurse | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2020-03-20 |
| 1588209423 | Murphi E Sparkman | Physician Assistant | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2019-11-14 |
| 1427515568 | Markie Ryan Carlock | Licensed Practical Nurse | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2019-02-25 |
| 1790241370 | Lori Ishman | Licensed Practical Nurse | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2019-02-19 |
| 1063978757 | Nicole Brown | Licensed Practical Nurse | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2019-02-18 |
| 1093211732 | Jessica Williams | Licensed Practical Nurse | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2018-04-02 |
| 1376052795 | Jennifer Robertson | Licensed Practical Nurse | 781 Grand Casino Blvd, Shawnee, OK 74804 | 2017-09-28 |
| 1487011169 | Stephanie Ruby | Registered Nurse | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2016-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063699 | Isaac Benjamin Gray | Student in an Organized Health Care Education/Training Program | 4010 Blaine Road, Shawnee, OK 74804 | 2019-10-06 |
| 1750863775 | Dillon Gibson | Specialist/Technologist | Oklahoma Baptist University, 500 W. University, Shawnee, OK 74804 | 2018-09-06 |
| 1912368242 | Peggy Baker | Occupational Therapist | 7602 N. Kickapoo, Shawnee, OK 74804 | 2016-03-15 |
| 1861731093 | Shariff Mohammed El-assi | Behavioral Analyst | 45 Crown Point, Shawnee, OK 74804 | 2013-02-07 |
| 1902103112 | Action Physical Therapy & Rehabilitation, Pllc | Physical Therapist | 2506 N Harrison, Shawnee, OK 74804 | 2011-02-24 |
| 1639493315 | Oklahoma Em - 1 Medical Services,p.c. | Emergency Medicine | 1102 W.macarthur, Shawnee, OK 74804 | 2010-03-24 |
| 1790989473 | Eastern Oklahoma Radiation Associates, LLC | Radiology | 3700 N Kickapoo Ave Ste 108, Shawnee, OK 74804 | 2007-06-14 |
| 1821210444 | Mickey Sehorn D.d.s., P.C. | Dentist | 1601 Airport Drive, Shawnee, OK 74804 | 2007-05-03 |
| 1760525711 | Leanna Rae Olsen | Registered Nurse | 1500 N. Kickapoo, Suite #4, Shawnee, OK 74804 | 2007-02-15 |
| 1467517920 | Mahmoud Abdel-fattah Khalifa | Pathology | Unity Health Center, 1102 West Macarthur, Shawnee, OK 74804 | 2006-12-26 |
| Find all providers in zip 74804 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275167397 | Kari Dawn Campbell | Nurse Practitioner | 4306 N Pottenger Ave, Shawnee, OK 74804-1267 | 2020-02-27 |
| 1609400266 | Kelly Elaine Bryden | Nurse Practitioner | 5117 Mccoy St, Shawnee, KS 66226-3807 | 2020-02-23 |
| 1316578842 | Amanda M Rigney | Nurse Practitioner | 322 S Aydelotte Ave, Shawnee, OK 74801-7611 | 2020-02-03 |
| 1326686767 | Jessica J. Hinchcliff | Nurse Practitioner | 5615 Maurer Rd, Shawnee, KS 66217-9766 | 2019-12-17 |
| 1023652815 | Sabrina Macalister | Nurse Practitioner | 30 Redbud Ln, Shawnee, OK 74801-8732 | 2019-11-05 |
| 1093364622 | Christiana Archibong | Nurse Practitioner | 21508 W 51st Pl, Shawnee, KS 66226-9731 | 2019-09-06 |
| 1003379728 | Marta Beshe | Nurse Practitioner | 5818 Theden St, Shawnee, KS 66218-9232 | 2019-04-09 |
| 1902370802 | Kelli Le Cox | Nurse Practitioner | 624 W Independence St Ste 116, Shawnee, OK 74804-4329 | 2019-01-14 |
| 1497243851 | Kendra Kirkendall | Nurse Practitioner | 421 N Beard Ave, Shawnee, OK 74801-6715 | 2018-05-01 |
| 1972975092 | Kristina Feezor | Nurse Practitioner | 1904 Gordon Cooper Dr, Shawnee, OK 74801-8603 | 2015-10-28 |
| Find all providers in SHAWNEE | ||||
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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.