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General NPI Number Information
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NPI Number | 1780156893
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Entity Type | Organization
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Legal Business Name | PREMIER FAMILY HEALTH AND WELLNESS PLLC
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Dates
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Enumeration Date | 12/31/2018
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 201 OAK DR S STE 203
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City | LAKE JACKSON
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State | TX
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Zip | 77566-5627
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Country | US
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Telephone | 979-297-9086
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Fax | 844-971-6888
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Provider Business Mailing Address
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Address Line | 201 OAK DR S STE 203
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City | LAKE JACKSON
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State | TX
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Zip | 77566-5627
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Country | US
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Telephone | 979-297-9086
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Fax | 844-971-6888
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRYSTA DANAE THOMPSON
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Credential | DNP, APRN, FNP-C
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Telephone | 979-297-9086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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