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General NPI Number Information
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NPI Number | 1114494077
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Entity Type | Individual
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Provider Name | CRYSTAL JEAN ONEAL NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/30/2018
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 10337 PAISLEY RD
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City | YUKON
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State | OK
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Zip | 73099-7859
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Country | US
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Telephone | 405-408-9753
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Fax |
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Provider Business Mailing Address
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Address Line | 10337 PAISLEY RD
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City | YUKON
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State | OK
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Zip | 73099-7859
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 97660
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 00097660
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 97660
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License Number State | OK
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