Provider Demographics
NPI:1750790556
Name:HARPER, CRYSTAL (MSN, APRN, AGCNS-BC)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:MSN, APRN, AGCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W 38TH ST STE 308
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6406
Mailing Address - Country:US
Mailing Address - Phone:512-324-3540
Mailing Address - Fax:512-324-3541
Practice Address - Street 1:1600 W. 38TH STREET
Practice Address - Street 2:SUITE 308
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-324-3540
Practice Address - Fax:512-324-3541
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126020364SA2200X, 364SG0600X
TX126020364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology