MEDICARE: CHRISTIANA CRISWELL

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	163W00000X	Registered Nurse	971574	TX

General Provider Information

NPI Number	:	1811840226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIANA CRISWELL

Provider Business Mailing Address
First Line	:	200 N VERMONT AVE APT 232
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4974
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 N VERMONT AVE APT 232
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4974
Country	:	US
Telephone Number	:	346-760-2591
Fax Number	:

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

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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Directions to “ CHRISTIANA CRISWELL ” Practice Location

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