Provider Demographics
NPI:1356018923
Name:SUTTON, CRISTEN (APRN)
Entity Type:Individual
Prefix:
First Name:CRISTEN
Middle Name:
Last Name:SUTTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CRISTI
Other - Middle Name:MARIE
Other - Last Name:COBURN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2820 FOREST GROVE DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1856
Mailing Address - Country:US
Mailing Address - Phone:972-979-3119
Mailing Address - Fax:
Practice Address - Street 1:8160 WALNUT HILL LN STE 220
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4354
Practice Address - Country:US
Practice Address - Phone:214-750-0980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX666334163WW0101X
TX1049022363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory