Provider Demographics
NPI:1215963426
Name:CRISTY, DONNA MICHELLE (NP-BC)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MICHELLE
Last Name:CRISTY
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:701-323-8253
Practice Address - Street 1:414 N 7TH ST
Practice Address - Street 2:3RD FLOOR, OB/GYN
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4423
Practice Address - Country:US
Practice Address - Phone:701-323-6543
Practice Address - Fax:701-323-8253
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX684133163W00000X, 363LF0000X
NDR39847363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDR39847OtherNORTH DAKOTA BOARD OF NURSING