Crystal Goss
Individual provider Active NPI School Registered Nurse · Aztec, NM
NPI 1770225229 · NPPES record last updated Apr 13, 2022
Key facts
- NPI
- 1770225229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Registered Nurse 163WS0200X
- License
- 86330 (NM)
- Practice address
- 507 S Park Ave
Aztec, NM 87410-2253 - Phone
- (505) 334-9469
- NPI assigned
- Apr 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86330 | NM | MD | School Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse |
163WS0200X | 86330 | NM | Yes |
Addresses
Primary practice location
507 S Park Ave
Aztec, NM 87410-2253
Mailing address
111 Road 3000
Aztec, NM 87410-9501
Other providers in Aztec, NM
- Aimee Aline Geiger
- Amber Gipson
- Suzette Lorraine Gordon
- Margaret Irene Gores
- Janet Lee Gorham
- Summer Graham
- Sara Gutierrez
- Roy Edward Harrington
- Savannah Claire Hazelwood
- Gordon Henriksen
All providers in Aztec, NM · School Registered Nurse in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.