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General NPI Number Information
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NPI Number | 1417520065
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Entity Type | Individual
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Provider Name | KRYSTAL A BUCKRIDGE APRN
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Gender | Female
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 388 S MAIN ST STE 440
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City | AKRON
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State | OH
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Zip | 44311-4407
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Country | US
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Telephone | 909-679-3482
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Fax |
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Provider Business Mailing Address
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Address Line | 5430 DOWNINGSGATE CIR NW
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City | CANTON
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State | OH
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Zip | 44718-3813
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0029346
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0029346
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License Number State | OH
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