Healthcare Provider Details

I. General information

NPI: 1528568490
Provider Name (Legal Business Name): KRISTY MARIE SCHRYVER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2018
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PREMIER DR UNIT A
CRESTVIEW FL
32539-3246
US

IV. Provider business mailing address

9500 S DADELAND BLVD STE 200
MIAMI FL
33156-2866
US

V. Phone/Fax

Practice location:
  • Phone: 850-477-2597
  • Fax: 866-939-1533
Mailing address:
  • Phone: 786-530-3820
  • Fax: 305-675-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9388876
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9388876
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: