Healthcare Provider Details

I. General information

NPI: 1598509663
Provider Name (Legal Business Name): KRYSTAL HERLIHY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRYSTAL AMARAL

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BOSTON MEDICAL CENTER PLACE
BOSTON MA
02118
US

IV. Provider business mailing address

960 MASSACHUSETTS AVE FL 2
BOSTON MA
02118
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-6950
  • Fax:
Mailing address:
  • Phone: 617-414-5405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11045782
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2319484
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberRN2319484
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: