Provider Demographics
NPI:1700472727
Name:FMURA, KRYSTIN GREER (FNP)
Entity Type:Individual
Prefix:
First Name:KRYSTIN
Middle Name:GREER
Last Name:FMURA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 FOUNTAIN BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-8540
Mailing Address - Country:US
Mailing Address - Phone:717-368-3817
Mailing Address - Fax:
Practice Address - Street 1:2901 BLUE RIDGE RD STE 203
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6423
Practice Address - Country:US
Practice Address - Phone:919-784-6818
Practice Address - Fax:919-784-6828
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC5013961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program