License Verification

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CRYSTAL DIANNA SMITHEY

License Number: PA9104863

Data As Of 5/20/2024

Profession
Physician Assistant
License
PA9104863
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
11/17/2008
Address of Record
123 Baptist Way
Baptist Hospital
PENSACOLA, FL 32503
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
9400 University Parkway Baptist Nine Mile
PENSACOLA, FL 32514
Address
1110 Gulf Breeze Parkway Baptist Hospital
GULF BREEZE, FL 32561
Address
8888 Navarre Parkway
NAVARRE, FL 32566
Name Relationship Profession License Effective Date
ALLISS, SAMIR JOSE Supervising Prescribing Practitioner Osteopathic Physician 7247 06/01/2023
BLAIR, AMANDA Supervising Prescribing Practitioner Osteopathic Physician 16098 10/17/2023
BOUCHER, JEROMY TRAVIS Supervising Prescribing Practitioner Osteopathic Physician 15599 08/01/2023
BRANTLEY, MITCHELL DAVID Supervising Prescribing Practitioner Medical Doctor 87928 06/01/2023
BUNYASARANAND, JOHN C Supervising Prescribing Practitioner Osteopathic Physician 18810 08/01/2023
CANDELARIA, NOELANI ARANGO Supervising Prescribing Practitioner Osteopathic Physician 17870 08/09/2023
DENNISON, CHARLTON PAIGE Supervising Prescribing Practitioner Medical Doctor 121535 06/01/2023
DOLISTER, MICHAEL JAN Supervising Prescribing Practitioner Medical Doctor 66315 09/28/2023
EDLER, RAYME MICHELLE Supervising Prescribing Practitioner Medical Doctor 109913 08/01/2023
HOLCOMBE, BENJAMIN WILLIS Supervising Prescribing Practitioner Medical Doctor 112819 08/01/2023
JACKSON, CORINNE SOKOLIK Supervising Prescribing Practitioner Medical Doctor 116991 06/01/2023
KHAN, MUHAMMAD Supervising Prescribing Practitioner Osteopathic Physician 16991 09/08/2023
KLEIN, JEFFREY GEORGE Supervising Prescribing Practitioner Medical Doctor 143907 06/01/2023
LUTHIN, WILLIAM NOLAN Supervising Prescribing Practitioner Medical Doctor 122535 06/01/2023
MAUREAU, MICHELLE MARIE DO Supervising Prescribing Practitioner Osteopathic Physician 9862 12/07/2023
MCINTOSH, NATHAN PHILIP Supervising Prescribing Practitioner Medical Doctor 159274 11/03/2023
MCINTOSH, SHELBY WAGNER Supervising Prescribing Practitioner Osteopathic Physician 19726 07/02/2023
MUNCY, TYLAN ANDREW Supervising Prescribing Practitioner Medical Doctor 147733 06/01/2023
NABERS, GREGORY WAYNE Supervising Prescribing Practitioner Medical Doctor 122995 06/01/2023
OWENBY, LAUREN Supervising Prescribing Practitioner Osteopathic Physician 12963 12/12/2023
PATRONI, CLYDE JOSEPH JR Supervising Prescribing Practitioner Medical Doctor 100780 06/01/2023
PRICE, CHRISTOPHER WAYNE Supervising Prescribing Practitioner Osteopathic Physician 17607 08/01/2023
RILEY, SCOTT IVAN Supervising Prescribing Practitioner Medical Doctor 101153 08/01/2023
SCHANDER, ARTUR Supervising Prescribing Practitioner Osteopathic Physician 15691 10/18/2023
TRUJILLO, DEBORAH JOY Supervising Prescribing Practitioner Medical Doctor 146744 07/25/2023
VILLARREAL, EUGENIO Supervising Prescribing Practitioner Medical Doctor 162890 03/28/2024
WELLS, BRANDEN LAMAUND Supervising Prescribing Practitioner Medical Doctor 82540 06/01/2023
WILLIAMS, SHANNON JEAN ROBINSON Supervising Prescribing Practitioner Medical Doctor 148129 06/01/2023

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Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 5/20/2024



* To find out more about Approved Providers, or ask a provider why the course you took is not yet listed, please visit our Continuing Education Providers page.


** Personal Development is limited to no more than 3 hours per renewal cycle. Any personal development hours in excess of this 3 hour maximum cannot be used for renewal and have been subtracted from the total available for renewal.


Please do not fax proof of Continuing Education hours to the Board Office until you have received your renewal notice in the mail.


For instructions on how to request a license certification of your Florida license to be sent to another state from the Florida Department of Health, please visit the License Certifications web page.