Healthcare Provider Details

I. General information

NPI: 1982126306
Provider Name (Legal Business Name): CRYSTAL THOMPSON BAUMANN ARNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CRYSTAL ROSE THOMPSON ARNP, FNP-C

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 07/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 W NEWBERRY RD STE 409
GAINESVILLE FL
32605
US

IV. Provider business mailing address

6440 W NEWBERRY RD STE 409
GAINESVILLE FL
32605-4370
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-6161
  • Fax: 352-333-6162
Mailing address:
  • Phone: 352-333-6161
  • Fax: 352-333-6162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF05170126
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9294210
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: