Individual
CRYSTAL STAR GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2322 S MAIN ST, FORT SCOTT, KS 66701-3026
(620) 223-8040
(620) 223-8002
Mailing address
PO BOX 1832, PITTSBURG, KS 66762-1832
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
80233
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110931219
MEDICARE
KS
05
—
200985650A
—
OK
05
—
201331240A
—
KS
05
—
420096347
—
MO
Enumeration date
07/28/2020
Last updated
05/31/2023
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