Crystal Sue Black, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP138623 Issued in TX

Practice address

625 W Central Texas Expy
Harker Heights, TX 76548-1600

Phone

(254) 690-0618

Fax

(254) 690-0462

NPI assigned

Oct 15, 2018

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": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1154897379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 CROSSLAKE PKWY",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126986",
            "telephone_number": "254-666-2999",
            "fax_number": "254-666-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W CENTRAL TEXAS EXPY",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765481600",
            "telephone_number": "254-690-0618",
            "fax_number": "254-690-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CRYSTAL",
        "middle_name": "SUE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP138623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BHH of Bell County and Region, LLC
• Brian Robert Bickel, DDS
• Bio-Medical Applications of Texas, Inc.
• Kathleen Elizabeth Bishop, PHARM D.
• Jennifer Lynn Bittner, LPC
• Lakeisha Vashawn Blackshear
• Traci Lynn Blanco
• Donald Gene Bockin, O.D.
• Andrea Leigh Boen, LPC
• Bola Elemuren MD. PA

• Nurse Practitioner in Harker Heights, TX
• Providers in Harker Heights, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.