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General NPI Number Information
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NPI Number | 1841917085
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Entity Type | Individual
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Provider Name | CRYSTAL MARIE PENA NP
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Gender | Female
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 345 S WATER ST
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City | CORPUS CHRISTI
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State | TX
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Zip | 78401-2819
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Country | US
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Telephone | 361-500-0660
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Fax | 201-812-7729
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Provider Business Mailing Address
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Address Line | 5224 75TH ST STE D
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City | LUBBOCK
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State | TX
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Zip | 79424-2525
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Country | US
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Telephone | 806-712-1096
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Fax | 806-771-2093
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1090349
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License Number State | TX
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