Provider Demographics
NPI:1053194738
Name:CONLEY, CRYSTAL ANN (APRN)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ANN
Last Name:CONLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:
Other - Last Name:JANZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2920 ADAMS RD STE 100A
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-1032
Mailing Address - Country:US
Mailing Address - Phone:580-736-3557
Mailing Address - Fax:888-805-0577
Practice Address - Street 1:2920 ADAMS RD STE 100A
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1032
Practice Address - Country:US
Practice Address - Phone:580-736-3557
Practice Address - Fax:188-823-6307
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK214841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily