Crystal Lee Komp, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

149023-32 Issued in WI

Practice address

N8150 Amundson Coulee Rd
Holmen, WI 54636

Phone

(717) 343-8744

NPI assigned

Sep 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1770252173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N8150 AMUNDSON COULEE RD",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "54636",
            "telephone_number": "717-343-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N8150 AMUNDSON COULEE RD",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "54636",
            "telephone_number": "717-343-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMP",
        "first_name": "CRYSTAL",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": "CNM07255",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "483",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WI",
            "license": "149023-32",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer C Klonecki, RN
• Leila Diane Koehler
• Tiphany Louise Kokott, RN
• Audrey Koller, PTA
• Jeffrey G Komay, PTA
• Jennifer Koop, RN
• Michelle Rae Krug, OTR/L
• Madelyn Anne Kuck
• John Walter Lace, PHD
• Kabre Lynn Lagrange

• Advanced Practice Midwife in Holmen, WI
• Providers in Holmen, WI by specialty
• Advanced Practice Midwife in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.