Provider Demographics
NPI:1538811054
Name:SWINK, CRYSTON E (FNP-BC)
Entity type:Individual
Prefix:
First Name:CRYSTON
Middle Name:E
Last Name:SWINK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16037 RIVER RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:MI
Mailing Address - Zip Code:48451-8593
Mailing Address - Country:US
Mailing Address - Phone:810-610-6320
Mailing Address - Fax:
Practice Address - Street 1:16037 RIVER RIDGE TRL
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:MI
Practice Address - Zip Code:48451-8593
Practice Address - Country:US
Practice Address - Phone:810-610-6320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704223887363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily