Provider Demographics
NPI:1629679279
Name:BAKER, CRYSTAL LYNN (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:LYNN
Last Name:BAKER
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:MISS
Other - First Name:CRYSTAL
Other - Middle Name:LYNN
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 9662
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72033-9662
Mailing Address - Country:US
Mailing Address - Phone:501-852-1363
Mailing Address - Fax:501-852-1364
Practice Address - Street 1:108 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-3362
Practice Address - Country:US
Practice Address - Phone:479-968-7170
Practice Address - Fax:479-968-7607
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR125821363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily