Chrystal Moon Nystuen, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN0332510 Issued in CO

Practice address

1711 E Evans Ave
Pueblo, CO 81004-3349

Phone

(719) 543-9751

NPI assigned

Feb 27, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1063979862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 E EVANS AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 E EVANS AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043349",
            "telephone_number": "719-543-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYSTUEN",
        "first_name": "CHRYSTAL",
        "middle_name": "MOON",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CO",
            "license": "PN0332510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Elizabeth Novotny, PHARMD
• NP Primary Wellness
• Dennis Nuding, COTA/L
• Eva Nunez, LPC
• Noelle R Nunn, LSW
• Denise O'Cana
• Tony O'Cana I, B.A. SOCIOLOGY
• Emily O'Neil, MS/CCC-SLP
• Cathleen Lynn O'Neill, MSW, LCSW
• Oakshire Gardens

• Licensed Practical Nurse in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Licensed Practical Nurse in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.