Healthcare Provider Details

I. General information

NPI: 1265318281
Provider Name (Legal Business Name): CRYSTAL SULEE SENTER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX L
HAYSI VA
24256-0169
US

IV. Provider business mailing address

284 PATSY LN
HAYSI VA
24256-6057
US

V. Phone/Fax

Practice location:
  • Phone: 276-865-7155
  • Fax:
Mailing address:
  • Phone: 276-218-0169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024194309
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: