Healthcare Provider Details

I. General information

NPI: 1508718024
Provider Name (Legal Business Name): KRYSTLE CALHOUN APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17201 CIVIC ST
OKEECHOBEE FL
34974
US

IV. Provider business mailing address

340 21ST CT SW
VERO BEACH FL
32962-3368
US

V. Phone/Fax

Practice location:
  • Phone: 863-763-0271
  • Fax:
Mailing address:
  • Phone: 561-601-0712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11038120
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: