Healthcare Provider Details

I. General information

NPI: 1013643345
Provider Name (Legal Business Name): CHRYSTAL H DOYLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9407 CUMBERLAND RD
NEW KENT VA
23124-2029
US

IV. Provider business mailing address

11357 NUCKOLS RD # 2124
GLEN ALLEN VA
23059-5504
US

V. Phone/Fax

Practice location:
  • Phone: 804-966-2242
  • Fax:
Mailing address:
  • Phone: 804-889-2917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRYSTAL DOYLE
Title or Position: OWNER & NURSE PRACTITIONER
Credential: FNP-BC, PMHNP-BC
Phone: 804-889-2927