MRS. CRYSTAL JEAN LOOSE (NPI# 1821406547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821406547 |
| Entity Type | Individual |
| Full Name | MRS. CRYSTAL JEAN LOOSE |
| Other Name | CRYSTAL JEAN WAITE |
| Credential | PA-C |
| Practice Address |
1705 Warren Ave Suite 101-103 Williamsport PA 17701-2647 |
| Mailing Address |
1201 Grampian Blvd Williamsport PA 17701-1900 |
| Practice Telephone | 5703212020 |
| Practice Fax Number | 5703207576 |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2017-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
MA056962 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1705 WARREN AVE SUITE 101-103 |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-2647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992702682 | Kenneth Robert Durrwachter | Family Medicine | 1705 Warren Ave, Suite 208, Williamsport, PA 17701-2647 | 2005-07-07 |
| 1043862824 | Karen A Armson | Physical Therapist | 1705 Warren Ave, Williamsport, PA 17701-2647 | 2019-07-12 |
| 1558913202 | Shari Mcelwain Berthold | Physical Therapist | 1705 Warren Ave, Williamsport, PA 17701-2647 | 2019-07-12 |
| 1740832609 | Joan Winslow | Physical Therapist | 1705 Warren Ave, Williamsport, PA 17701-2647 | 2019-07-11 |
| 1184276065 | Kristen Durrwachter | Physical Medicine & Rehabilitation | 1705 Warren Ave, Williamsport, PA 17701-2647 | 2019-07-11 |
| 1538563804 | Amber Snyder | Specialist/Technologist, Other | 1705 Warren Ave, Suite 103, Williamsport, PA 17701-2647 | 2014-10-15 |
| 1467865204 | Erin Foley | Physician Assistant | 1705 Warren Ave, Suite 101-103, Williamsport, PA 17701-2647 | 2014-06-10 |
| 1215361639 | Megan Ann Sechrist | Physician Assistant | 1705 Warren Ave, Suite 204-205, Williamsport, PA 17701-2647 | 2013-08-22 |
| 1598198525 | Kelly Douglass | Nurse Practitioner | 1705 Warren Ave, Suite 303, Williamsport, PA 17701-2665 | 2013-08-13 |
| 1700225067 | Bryna Lee Rickenbach | Audiologist | 1705 Warren Ave, Suite 204-205, Williamsport, PA 17701-2647 | 2013-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184267809 | Charlene Angella Pitter | Nurse Practitioner | 170 Warren Ave, Williamsport, PA 17701 | 2019-10-25 |
| 1396395299 | Susan E Fetzer | Occupational Therapy Assistant | Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 | 2019-09-13 |
| 1184280984 | Craig Andrew Tuller | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 | 2019-05-16 |
| 1760048045 | Michael Harvey | Student in an Organized Health Care Education/Training Program | 740 High St. Suite 4001, Williamsport, PA 17701 | 2019-05-13 |
| 1275196008 | Olivia Fladmark | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 | 2019-04-17 |
| 1528551231 | Mark Hampton Chiropractic Inc. | Durable Medical Equipment & Medical Supplies | 1111 East 3rd Street, Williamsport, PA 17701 | 2018-06-08 |
| 1548710882 | Central Pennsylvania Rehabilitation Medicine, Inc | Physical Medicine & Rehabilitation | 460 River Ave Ste 1, Williamsport, PA 17701 | 2016-10-11 |
| 1376096784 | Christine Kessler | Physician Assistant | One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 | 2016-08-02 |
| 1629440276 | Matthew Ray Rebuck | Specialist/Technologist | 220 N Reach Rd, Williamsport, PA 17701 | 2015-10-22 |
| 1508237223 | Neihl Williamson | Physician Assistant | 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 | 2015-10-08 |
| Find all providers in zip 17701 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467865204 | Erin Foley | Physician Assistant | 1705 Warren Ave, Suite 101-103, Williamsport, PA 17701-2647 | 2014-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450087 | Mary Baich | Physician Assistant | 1050 Bower Hill Rd Ste 208, Pittsburgh, PA 15243-1868 | 2020-06-08 |
| 1972145134 | Emilie A Simone | Physician Assistant | 1050 Bower Hill Rd Ste 309, Pittsburgh, PA 15243-1870 | 2019-10-09 |
| 1518524339 | Nicholas Vernoy Smith | Physician Assistant | 510 South Aiken Avenue, Suite Eg-01 East Wing Shadyside Hospital, Pittsburgh, PA 15232-1505 | 2019-05-28 |
| 1689131757 | Amanda Furst | Physician Assistant | 9100 Babcock Blvd Ste 4828, Pittsburgh, PA 15237-5815 | 2019-02-26 |
| 1659845295 | Alexis Kimes | Physician Assistant | 200 Lothrop St Fl 4, Pittsburgh, PA 15213-2536 | 2019-01-16 |
| 1427530831 | Jordan L Ball | Physician Assistant | 30 Hope Dr # 1200, Hershey, PA 17033-2036 | 2018-08-31 |
| 1740707298 | Robyn Mcnamee | Physician Assistant | 142 Clearview Cir Ste 110, Butler, PA 16001-1565 | 2017-08-25 |
| 1831648336 | Hollie Anne Ramaley | Physician Assistant | 624 E End Ave, Pittsburgh, PA 15221-3424 | 2016-09-25 |
| 1083169890 | Ellen Cannon | Physician Assistant | 1023 Marlin Dr, West Chester, PA 19382-2360 | 2016-08-22 |
| 1295182491 | Emily Tercek | Physician Assistant | 620 Howard Ave Fl 7, Altoona, PA 16601-4804 | 2016-05-17 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSPORT |
| Zip Code | 17701 |
Please comment or provide details below to improve the information on MRS. CRYSTAL JEAN LOOSE.
| 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.