Healthcare Provider Details

I. General information

NPI: 1013830868
Provider Name (Legal Business Name): CHRYSTAL NICOLE REES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10707 PACIFIC ST STE 101
OMAHA NE
68114-4762
US

IV. Provider business mailing address

4872 S 170TH ST
OMAHA NE
68135-1444
US

V. Phone/Fax

Practice location:
  • Phone: 402-397-7989
  • Fax:
Mailing address:
  • Phone: 402-499-2339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number117118
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: