Provider Demographics
NPI:1851878136
Name:CHRISTIAN, CRYSTAL ISOLA (ARNP)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:ISOLA
Last Name:CHRISTIAN
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 SANIBEL AVE APT A
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34951-2272
Mailing Address - Country:US
Mailing Address - Phone:386-868-9639
Mailing Address - Fax:
Practice Address - Street 1:15310 AMBERLY DR STE 250
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1642
Practice Address - Country:US
Practice Address - Phone:888-880-3451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK219858363L00000X
MI4704419420363L00000X
NJ26NJ15178200363L00000X
MDAC007404363L00000X
CA95033776363L00000X
FL9312954363L00000X
OH0037573363L00000X
FLAPRN9312954363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner