Crystal L Fann

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

1712359 Issued in AK

Practice address

130 S Willow St Ste 9
Kenai, AK 99611-9107

Phone

(907) 935-3084

NPI assigned

Nov 8, 2024

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

Electronic endpoints 1

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": "1731024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1275357014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S WILLOW ST STE 9",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996119107",
            "telephone_number": "907-935-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S WILLOW ST STE 9",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996119107",
            "telephone_number": "907-935-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANN",
        "first_name": "CRYSTAL",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-08",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "AK",
            "license": "1712359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Heartsandhandsofcare.com",
            "affiliation": "N",
            "endpointDescription": "Heartsandhandsofcare,inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "130 S Willow St Ste 9",
            "city": "Kenai",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996119107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Terri Lee Elliott, D.O.
• Tiphanie Lanae Eskue
• Expedition Nutrition Services LLC
• Josephine E Fadden
• Family and Forensic Counseling Services LLC
• Michael Farahjood
• Edward Dean Farnes
• Krystofer Ceryn Fenn
• Susan Karleen Fisk, CPM
• Liliia Flanagan

• All providers in Kenai, AK
• Personal Care Attendant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.