Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Crystal Gayle Self, CRNP

Individual provider Registered Nurse · NPI 1164984035

Mrs. Crystal Gayle Self, CRNP is a Nurse Practitioner in Birmingham, Alabama. Qualified in 2020, 6 years ago. Practices with Smith Lake Family Care LLC, an 8-clinician group and accepts Medicare assignment. Licensed in Alabama.

Years since qualifying
6
Licensed in
AL
In the registry since
2019
Specialties on file
2
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

2700 10th Ave S Ste 444
Birmingham, AL 35205-1250
Phone: (205) 723-0088
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1-105083 (AL)
Registered Nurse Taxonomy 163W00000X · Licence 1-105083 (AL)

Record details

NPI number1164984035
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedApril 1, 2019
Last updated in NPPESMay 4, 2021
Certification dateMay 4, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Smith Lake Family Care Llc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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