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General NPI Number Information
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NPI Number | 1255948089
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Entity Type | Individual
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Provider Name | KRYSTAL JANE MCNUTT PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 5353 N UNION BLVD STE 202
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-2069
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Country | US
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Telephone | 970-806-3225
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Fax |
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Provider Business Mailing Address
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Address Line | 26010 OAK RIDGE DR STE 107
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1972
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Country | US
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Telephone | 281-815-0899
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Fax | 281-528-1107
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY.0006336
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License Number State | CO
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