Healthcare Provider Details

I. General information

NPI: 1295241461
Provider Name (Legal Business Name): CRYSTAL HUNT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRYSTAL HUTCHINS

II. Dates (important events)

Enumeration Date: 12/23/2017
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1179 NW 64TH TER
GAINESVILLE FL
32605-4218
US

IV. Provider business mailing address

4881 NW 8TH AVE SUITE 2
GAINESVILLE FL
32605-4582
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-5400
  • Fax: 352-333-5404
Mailing address:
  • Phone: 352-416-1082
  • Fax: 352-373-6144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11002449
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: