Crystal Danae Van Dette, ARNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

ARNP 9268840 Issued in FL

Practice address

2919W Swann Ave 102
Tampa, FL 33609-4049

Phone

(813) 870-3971

NPI assigned

Mar 17, 2014

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1215353073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919W SWANN AVE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094049",
            "telephone_number": "813-870-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919W SWANN AVE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094049",
            "telephone_number": "813-870-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DETTE",
        "first_name": "CRYSTAL",
        "middle_name": "DANAE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-17",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP 9268840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent Thomas Van Berkum, MD
• Yumara Van Brackle, LCSW
• Joseph B Van Camp
• Chase Logan Van Dalen
• Annette Renae Van Den Bosch, PA-C
• Brittney Van Etten
• Wanda Van Harlinger, OTR/L
• Amanda Van Hook, APRN, FNP-BC
• Joshua John Van Horn, L.M.T.
• Jennifer Lynn Van Keulen, PA-C

• Gerontology Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.