Provider Demographics
NPI:1851878136
Name:CHRISTIAN, CRYSTAL ISOLA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:ISOLA
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 SANIBEL AVE APT A
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34951-2272
Mailing Address - Country:US
Mailing Address - Phone:386-868-9639
Mailing Address - Fax:
Practice Address - Street 1:1300 RED JOHN DR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32124-1075
Practice Address - Country:US
Practice Address - Phone:386-254-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2024-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9312954363L00000X
FL9312954363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner