Provider Demographics
NPI:1992331573
Name:SMITH - SHELTON, KRYSTAL NICOLE (PMHNP, FNP, CRNP)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:NICOLE
Last Name:SMITH - SHELTON
Suffix:
Gender:F
Credentials:PMHNP, FNP, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16592 HIGH DESERT PL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3044
Mailing Address - Country:US
Mailing Address - Phone:720-458-5413
Mailing Address - Fax:720-815-0397
Practice Address - Street 1:12760 STROH RANCH WAY STE 203
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7507
Practice Address - Country:US
Practice Address - Phone:720-458-5413
Practice Address - Fax:720-815-0397
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0104280-C-NP363LP0808X
AL1-146984363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health