Crystal Twynham MD PLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

39691 Issued in MN

Legal business name

CRYSTAL TWYNHAM MD PLC

Practice address

15552 68TH PL N
Maple Grove, MN 55311-3291

Phone

(931) 237-2265

Fax

(612) 594-8998

NPI assigned

Jan 15, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Crystal Ulani Twynham, MD

Title

Owner

Phone

(931) 237-2265

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1295049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1962707398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15552 68TH PL N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553113291",
            "telephone_number": "931-237-2265",
            "fax_number": "612-594-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15552 68TH PL N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553113291",
            "telephone_number": "931-237-2265",
            "fax_number": "612-594-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL TWYNHAM MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-15",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "TWYNHAM",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "ULANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-237-2265",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MN",
            "license": "39691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "514517100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ivori Darnicia Crawford, PHARMD
• Kelly Crenna, O.D.
• Lisa D. Cross, MA, LMFT
• James K Croston, MD
• Matthew Brandon Cruz, MA, LPCC, LADC
• CSL Rose Arbor
• Anthony Timothy Culbertson, PHARMD
• Curveball Counseling LLC
• CW Design PLLC
• D. Baker Therapy LLC

• Medical Specialty Clinic/Center in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Medical Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.