Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Crystal Gail Reneau, APRN-CNP

Individual provider Family Nurse Practitioner · NPI 1639942105

Crystal Gail Reneau, APRN-CNP is a Nurse Practitioner in Broken Arrow, Oklahoma. Qualified in 2023, 3 years ago. Practices with Broken Arrow Pain Specialist, LLC, a 2-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
3
Licensed in
OK
In the registry since
2023
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Practice location Address checks out

1129 S Aspen Ave
Broken Arrow, OK 74012-4859
Phone: (539) 367-1253
Fax: (539) 367-3311
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2028 Mahaney Ave, Tahlequah, OK 74464-5783 — (918) 992-6050

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 215764 (OK)

Record details

NPI number1639942105
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-CNP
Sole proprietorNo
NPI enumeratedNovember 6, 2023
Last updated in NPPESNovember 6, 2023
Certification dateNovember 6, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Broken Arrow Pain Specialist, Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Broken Arrow