Kristen Shayanne Crook, CPNP-PC

Individual provider Active NPI Pediatric Nurse Practitioner · Goldsboro, NC

NPI 1053781088 · NPPES record last updated Oct 29, 2024

Key facts

NPI
1053781088
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
5017769 (NC)
Practice address
2706 Medical Office PL
Goldsboro, NC 27534-9460
Phone
(919) 734-4736
NPI assigned
Oct 2, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5017769NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goldsboro Pediatrics PA Past
since Nov 3, 2024
Accepting new patients
Goldsboro Pediatrics PA Past Accepting new patients
Goldsboro Pediatrics PA Past
since Nov 3, 2024
Accepting new patients
Goldsboro Pediatrics PA Past
since Dec 24, 2023
Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kcrook@goldsboropeds.medentdirect.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5017769 NC Yes

Addresses

Primary practice location

2706 Medical Office PL
Goldsboro, NC 27534-9460

Mailing address

2706 Medical Office PL
Goldsboro, NC 27534-9462
Phone (919) 734-4736

Other providers in Goldsboro, NC

All providers in Goldsboro, NC · Pediatric Nurse Practitioner in North Carolina

Sources for this page

Verify at the official NPI Registry.