Provider Demographics
NPI:1659839611
Name:BUCHANAN, CRYSTAL KAY (NP-C)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:KAY
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:KAY
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6350 W ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8605
Mailing Address - Country:US
Mailing Address - Phone:800-355-3565
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:210 WESTWOOD PL STE 110
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7554
Practice Address - Country:US
Practice Address - Phone:615-206-2462
Practice Address - Fax:833-983-2043
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN192513163W00000X
TNAPN25508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse