Crystal Smith

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

56072 Issued in OK

Practice address

711 S Muskogee Ave
Tahlequah, OK 74464-4717

Phone

(918) 207-0078

NPI assigned

Feb 22, 2024

Sex

Female

Sole proprietor

Yes

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": "1708560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1184480774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480985",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741480985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S MUSKOGEE AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644717",
            "telephone_number": "918-207-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "OK",
            "license": "56072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Slosson
• Sharon C Smallwood, M.D.
• Hilary Jo Smiley, DDS
• Saundra Smith Moore, SCHOOL PSYCHOLOGIST
• Chelsea Elizabeth Smith, D.O.
• James W Smith, M.D.
• Jesse Smith, SPECIAL CARE PARA
• Karsten Tyrone Smith, PHARM. D
• Mark David Smith, DDS
• Martha J Smith, RN

• Psychiatric/Mental Health Clinical Nurse Specialist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.