CRYSTAL WAGNER (NPI# 1689049033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689049033 |
| Entity Type | Individual |
| Full Name | CRYSTAL WAGNER |
| Other Name | CRYSTAL CRUZE |
| Credential | APRN |
| Practice Address |
85 N Grand Ave Fort Thomas KY 41075-1793 |
| Mailing Address |
Po Box 18667 Erlanger KY 41018-0667 |
| Practice Telephone | 8595723617 |
| Practice Fax Number | 8595722326 |
| Mailing Telephone | 5133122247 |
| Mailing Fax Number | 8595722326 |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2020-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 3009831 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0229162 | 05 | |
| KY | 7100411630 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740812338 | Crystal Wagner | Behavioral Analyst | 1343 N Grand Ave Ste 200, Covina, CA 91724-4043 | 2020-02-11 |
| 1154842722 | Crystal Wagner | Counselor | 6013 S Redwood Rd, Taylorsville, UT 84123-5220 | 2017-07-04 |
| 1215393319 | Crystal Wagner | Physician Assistant | 18200 Katy Fwy, Houston, TX 77094-1285 | 2016-01-06 |
| Street Address |
85 N GRAND AVE |
| City | FORT THOMAS |
| State | KY |
| Zip Code | 41075-1793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467458745 | Kevin C Meyer | Emergency Medicine | 85 N Grand Ave, Fort Thomas, KY 41075 | 2005-06-22 |
| 1538760020 | Megan Sullivan | Registered Nurse | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2020-11-03 |
| 1407472699 | Rachael M Oakley | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2020-06-23 |
| 1720626856 | Natalya C Williams | Nurse Practitioner | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2019-12-19 |
| 1710537675 | Kaitlyn Gerrety | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2019-09-12 |
| 1578039632 | Samuel Quincy Gaines | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2018-10-16 |
| 1790209476 | Shelby Rene Mesch | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2017-08-03 |
| 1538681044 | Danielle Nichole Fryer | Registered Nurse | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2017-07-17 |
| 1427596675 | Donna Gentz | Physical Therapy Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2017-02-08 |
| 1063967495 | Cora E Mikesell | Physician Assistant | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2016-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023630472 | Reliable Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 604 South Fort Thomas Avenue, Fort Thomas, KY 41075 | 2020-05-08 |
| 1245878149 | A & A Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 604 South Ft. Thomas, Ft. Thomas, KY 41075 | 2019-12-11 |
| 1588213383 | Connect Counselors | Social Worker | 1051 Alexandria Pike, Suite 104, Fort Thomas, KY 41075 | 2019-09-05 |
| 1629634407 | Kristen Lynn Salvato | Counselor | 18 North Fort Thomas Avenue, Suite 109, Fort Thomas, KY 41075 | 2019-05-16 |
| 1306364872 | Mary Frances Scott | Developmental Therapist | 26 Burney Ln, Ft Thomas, KY 41075 | 2017-09-06 |
| 1881123057 | Samuel Barth | Specialist/Technologist | 33 Bellaire Place, Fort Thomas, KY 41075 | 2017-06-09 |
| 1669918371 | Jenna Weyer | Specialist/Technologist | 46 Fischer Lane, Fort Thomas, KY 41075 | 2017-01-19 |
| 1457723033 | Lauren Bradbury | Registered Nurse | 1201 N. Ft. Thomas Ave., Ft. Thomas, KY 41075 | 2015-10-22 |
| 1053639237 | Kathy H Kugler | Psychologist | 1201 South Ft Thomas Ave, Ft Thomas, KY 41075 | 2010-05-12 |
| 1104059229 | Shanna L Murray | Psychologist | 1000 S. Ft. Thomas Ave, Fort Thomas, KY 41075 | 2009-08-24 |
| Find all providers in zip 41075 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336596600 | Anthony Raley | Nurse Practitioner | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2016-05-17 |
| 1699182337 | Amy Michelle Nicholas | Nurse Practitioner | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2014-07-15 |
| 1619148855 | Lisa-marie Aders | Nurse Practitioner | 85 N Grand Ave, Fort Thomas, KY 41075-1793 | 2008-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891645 | K Tierney Lanham LLC | Nurse Practitioner | 6431 Regency Ln, Louisville, KY 40207-2309 | 2020-11-06 |
| 1922608827 | Heidi Denise Estes | Nurse Practitioner | 651 U.S. 31 W Bypass Ste 106, Bowling Green, KY 42101 | 2020-10-29 |
| 1124626700 | Mind & Body Wellness | Nurse Practitioner | 105 Bob White Path, Georgetown, KY 40324-6169 | 2020-10-15 |
| 1902404759 | Cassie Parr | Nurse Practitioner | 57 Melissa Branch Rd, Ary, KY 41712-8716 | 2020-10-14 |
| 1649877275 | Kristy Faith Statzer | Nurse Practitioner | 7533 Russellville Rd, Morgantown, KY 42261-9625 | 2020-10-06 |
| 1124635446 | Tori Crabtree | Nurse Practitioner | 1511 Valley Dr, Flatwoods, KY 41139-1889 | 2020-09-30 |
| 1518574235 | Margaret E Lambert | Nurse Practitioner | 2241 Abbeywood Rd, Lexington, KY 40515-1157 | 2020-09-27 |
| 1003422270 | Victoria Weis | Nurse Practitioner | 9301 Dayflower St Ste 100, Prospect, KY 40059-7585 | 2020-09-22 |
| 1598370694 | Candace Jones-martin | Nurse Practitioner | 111 Osbourne Way # 101, Georgetown, KY 40324-8004 | 2020-09-15 |
| 1588274161 | Karyn Michele Bentley | Nurse Practitioner | 210 Hoagland Hill Rd, Mount Washington, KY 40047-7583 | 2020-08-07 |
| Find all providers with the same taxonomy | ||||
| City | FORT THOMAS |
| Zip Code | 41075 |
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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.