Provider Demographics
NPI:1962083485
Name:GARNER, CRISTAL (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CRISTAL
Middle Name:
Last Name:GARNER
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 COUNTY ROAD 2303
Mailing Address - Street 2:
Mailing Address - City:RUSK
Mailing Address - State:TX
Mailing Address - Zip Code:75785-5942
Mailing Address - Country:US
Mailing Address - Phone:903-530-9824
Mailing Address - Fax:
Practice Address - Street 1:805 N DICKINSON DR
Practice Address - Street 2:
Practice Address - City:RUSK
Practice Address - State:TX
Practice Address - Zip Code:75785-1006
Practice Address - Country:US
Practice Address - Phone:903-683-3421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX900889163WP0808X
TX1097808363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health