Healthcare Provider Details

I. General information

NPI: 1205759339
Provider Name (Legal Business Name): CRYSTAL A MORGAN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 ARCHWAY CT
LYNCHBURG VA
24502-3159
US

IV. Provider business mailing address

2526 SUNNYMEADE RD
RUSTBURG VA
24588-3332
US

V. Phone/Fax

Practice location:
  • Phone: 434-382-1123
  • Fax: 434-317-7297
Mailing address:
  • Phone: 434-426-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024198251
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: