Provider Demographics
NPI:1114743606
Name:STROTHER, KRYSTAL LATRICE (FNP)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:LATRICE
Last Name:STROTHER
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10412 DISCOVERY LN
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-1643
Mailing Address - Country:US
Mailing Address - Phone:409-692-6787
Mailing Address - Fax:
Practice Address - Street 1:10412 DISCOVERY LN
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-1643
Practice Address - Country:US
Practice Address - Phone:409-692-6787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-29
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1176746363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty