Individual
CRYSTAL SUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28186563A
IN
363LF0000X
Family Nurse Practitioner
Primary
71005316A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0120129
—
OH
05
—
201276940
—
IN
Enumeration date
10/14/2014
Last updated
05/07/2026
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