Provider Demographics
NPI:1114494077
Name:ONEAL, CRYSTAL JEAN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:JEAN
Last Name:ONEAL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MS
Other - First Name:CRYSTAL
Other - Middle Name:JEAL
Other - Last Name:DEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10337 PAISLEY RD
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7859
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10337 PAISLEY RD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-7859
Practice Address - Country:US
Practice Address - Phone:405-408-9753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK97660363LG0600X, 363LA2200X
OK00097660363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care