Provider Demographics
NPI:1871204222
Name:AKUNNE, CRYSTAL CHINONYE (PMHNP)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:CHINONYE
Last Name:AKUNNE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 VICTORY AVE APT 305
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-7913
Mailing Address - Country:US
Mailing Address - Phone:214-724-5415
Mailing Address - Fax:
Practice Address - Street 1:2370 VICTORY AVE APT 305
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-7913
Practice Address - Country:US
Practice Address - Phone:214-724-5415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2021129229363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health