Crystal A Ciszek, FNP
Nurse Practitioner, Family in Jacksonville, FL. Individual provider (NPI-1).
NPI number1124486089
StatusActive
Last updated in NPPESSep 5, 2022
Details
- NPI
- 1124486089
- Entity type
- Individual (NPI-1)
- Name
- Crystal A Ciszek
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 8, 2016
- Certification date
- Sep 5, 2022
- Last updated
- Sep 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 11020853 | FL | Yes |
| 363LF0000X | Nurse Practitioner, Family | RN209456 | GA |
Other names
- Crystal A Ciszek (Former Name)
Practice location
10752 Deerwood Park Blvd Ste 100Jacksonville, FL 32256-4846
Phone 478-290-0677
Mailing address
463688 State Road 200, Ste 1#364
Yulee, FL 32097-0304
Phone 478-290-0677
Other practice locations
774 Highway 96
Bonaire, GA 31005-3300
Bonaire, GA 31005-3300
Phone 478-988-5711
104 Fairview Park Dr
Dublin, GA 31021-2500
Dublin, GA 31021-2500
Phone 478-272-1366 · Fax 478-277-1251
1831 E 71st St
Tulsa, OK 74136-3922
Tulsa, OK 74136-3922
Phone 866-949-0108
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