Provider Demographics
NPI:1811860950
Name:WYNTER, KRYSTAL D
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:D
Last Name:WYNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10630 EMORY PARK
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1893
Mailing Address - Country:US
Mailing Address - Phone:850-603-0324
Mailing Address - Fax:
Practice Address - Street 1:10630 EMORY PARK
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1893
Practice Address - Country:US
Practice Address - Phone:850-603-0324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1172740163WC0400X, 163WP0200X, 163WS0200X, 163WW0101X, 163W00000X, 163WD1100X, 163WG0000X, 163WH0200X, 163WH1000X, 163WI0500X, 163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn