Healthcare Provider Details

I. General information

NPI: 1841440583
Provider Name (Legal Business Name): CHRYSTAL LYNN BERMUDEZ F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3831 PIPER ST STE S220
ANCHORAGE AK
99508-4680
US

IV. Provider business mailing address

PO BOX 31001-4162
PASADENA CA
91110-4162
US

V. Phone/Fax

Practice location:
  • Phone: 907-212-4824
  • Fax: 907-212-4831
Mailing address:
  • Phone: 866-747-2455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13578
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209209
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: