Provider Demographics
NPI:1497507594
Name:HURON, KRYSTLE NICOLE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KRYSTLE
Middle Name:NICOLE
Last Name:HURON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:KRYSTLE
Other - Middle Name:NICOLE
Other - Last Name:GALINDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1162A ARNOLD CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON AFB
Mailing Address - State:SC
Mailing Address - Zip Code:29404-2101
Mailing Address - Country:US
Mailing Address - Phone:402-949-2553
Mailing Address - Fax:
Practice Address - Street 1:1162A ARNOLD CIR
Practice Address - Street 2:
Practice Address - City:CHARLESTON AFB
Practice Address - State:SC
Practice Address - Zip Code:29404-2101
Practice Address - Country:US
Practice Address - Phone:402-949-2553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily