Provider Demographics
NPI:1578180493
Name:CRUMPTON, KRISTEN KAY (DNP, APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:KAY
Last Name:CRUMPTON
Suffix:
Gender:F
Credentials:DNP, APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 WEBB RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4518
Mailing Address - Country:US
Mailing Address - Phone:813-882-9986
Mailing Address - Fax:813-341-3259
Practice Address - Street 1:615 MIDFLORIDA DR STE 1
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-4921
Practice Address - Country:US
Practice Address - Phone:863-455-8100
Practice Address - Fax:863-455-8099
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007749363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107436800Medicaid