Provider Demographics
NPI:1508569088
Name:ALANIZ, CRYSTAL (FNP-BC)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:ALANIZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4547 E ELMER GIRTZ DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IN
Mailing Address - Zip Code:47960-7387
Mailing Address - Country:US
Mailing Address - Phone:765-237-1225
Mailing Address - Fax:
Practice Address - Street 1:1165 N US HIGHWAY 421
Practice Address - Street 2:
Practice Address - City:DELPHI
Practice Address - State:IN
Practice Address - Zip Code:46923-8722
Practice Address - Country:US
Practice Address - Phone:765-564-2880
Practice Address - Fax:866-493-3120
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28241994A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care