KRYSTLE LACOLE OLIVER – Nurse Practitioner, NPI 1417543406

KRYSTLE LACOLE OLIVER is a healthcare provider. based in Minneapolis, Minnesota. specializing in NURSE PRACTITIONER. They hold a License No. 28734 (TN). The NPI Number for KRYSTLE LACOLE OLIVER is 1417543406

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
KRYSTLE LACOLE OLIVER
NPI
1417543406
Phone
Not provided
Address
100 WASHINGTON AVE S
Enumeration Date
15 December 2020
Last Update Date
19 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9017260843
Graduation Year
2020 (6 years ago)
PAC ID
7517351232
Group Practice PAC ID
5193860385
Professional Enrollment ID
I20220223001234
Address ID
TN381124403ME2693XEXTX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for KRYSTLE LACOLE OLIVER

  • 100 WASHINGTON AVE S

    MINNEAPOLIS, MN 554012110

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 20 Open Payments records for all available years, with a total value of $344.

Total Amount is formed as General ($344) + Research ($0) + Ownership ($0) = $344.

Last reported payment date: 2023-09-25 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($96).

Total Amount

$344

General + Research + Ownership

Payments

20

Total payment records

General Amount

$344

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-25

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-03-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220223001234INurse PractitionerTNTBD
I20220321000753INurse PractitionerMSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5193860385View full group profile
NameSpecialtyState
Nurse PractitionerTN
Internal MedicineTN
Nurse PractitionerTN
Physician AssistantTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN

Reviews

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Frequently asked questions

What is KRYSTLE LACOLE OLIVER's NPI number?
KRYSTLE LACOLE OLIVER's NPI is 1417543406 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to KRYSTLE LACOLE OLIVER?
You should see KRYSTLE LACOLE OLIVER as active in CMS-hosted NPPES data.
How would a patient describe KRYSTLE LACOLE OLIVER's focus?
For KRYSTLE LACOLE OLIVER, the primary taxonomy reads as Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is KRYSTLE LACOLE OLIVER associated with Minneapolis?
Public fields place KRYSTLE LACOLE OLIVER around Minneapolis, Minnesota. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for KRYSTLE LACOLE OLIVER is noted as December 15, 2020 where the registry provides it.

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