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NPI Code Detail

MEDICARE: KRYSTAL MICHELLE BEWLEY FNP

MEDICARE:   KRYSTAL MICHELLE BEWLEY  FNP
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
1363LF0000XFamily Nurse Practitioner721609TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902199755
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTAL MICHELLE BEWLEY FNP
Provider Business Mailing Address
First Line : 909 N FRONTAGE RD
Second Line :
City : VALLEY VIEW
State : TX
Zip : 76272-9227
Country : US
Telephone Number : 940-726-5750
Fax Number : 940-726-5721
Provider Business Practice Location Address
First Line : 909 N FRONTAGE RD
Second Line :
City : VALLEY VIEW
State : TX
Zip : 76272-9227
Country : US
Telephone Number : 940-726-5750
Fax Number : 940-726-5721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2011
Last Update Date : 07/21/2022

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Directions to “ KRYSTAL MICHELLE BEWLEY FNP” Practice Location

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