MEDICARE: CRYSTAL DARMIKA WHITE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R235444	MD

General Provider Information

NPI Number	:	1245000975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL DARMIKA WHITE

Provider Business Mailing Address
First Line	:	6503 ASSET DR
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-5834
Country	:	US
Telephone Number	:	240-353-9181
Fax Number	:

Provider Business Practice Location Address
First Line	:	3035 BRINKLEY RD APT 201
Second Line	:
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-6150
Country	:	US
Telephone Number	:	240-353-9181
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2024
Last Update Date	:	02/04/2026

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Directions to “ CRYSTAL DARMIKA WHITE ” Practice Location

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