Basic Information
| Provider Information | |||||||||
| NPI: | 1750790556 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARPER | ||||||||
| FirstName: | CRYSTAL | ||||||||
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| Credential: | MSN, APRN, AGCNS-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 W 38TH ST STE 308 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787316406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123243540 | ||||||||
| FaxNumber: | 5123243541 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 W. 38TH STREET | ||||||||
| Address2: | SUITE 308 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123243540 | ||||||||
| FaxNumber: | 5123243541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2014 | ||||||||
| LastUpdateDate: | 10/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SA2200X | AP126020 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health | 364SG0600X | AP126020 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Gerontology | 364S00000X | 126020 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist |
No ID Information.