Individual provider Active NPI

Gina Crudden, DNP, APRN-CNS

  • Gerontology Clinical Nurse Specialist
  • Papillion, NE
National Provider Identifier
1215768940
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X
License
M0101961 Issued in OK
Practice address
2210 Park Crest Dr
Papillion, NE 68133-4449
Phone
(817) 504-5024
NPI assigned
Aug 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Clinical Nurse Specialist 364SG0600X M0101961 OK Primary

Addresses

Primary practice location

2210 Park Crest Dr
Papillion, NE 68133-4449

Mailing address

2210 Park Crest Dr
Papillion, NE 68133-4449
Phone (817) 504-5024

Other practice location 1

720 N 87th St
Omaha, NE 68114-2806
Phone (817) 504-5024

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
M0101961OKMDGerontology Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1215768940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 PARK CREST DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "681334449",
            "telephone_number": "817-504-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 PARK CREST DR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "681334449",
            "telephone_number": "817-504-5024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 N 87th St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681142806",
            "country_code": "US",
            "telephone_number": "817-504-5024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUDDEN",
        "first_name": "GINA",
        "credential": "DNP, APRN-CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "OK",
            "license": "M0101961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.