=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356281067
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRYSTAL DOBRZYN PMHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2026
-----------------------------------------------------
Last Update Date | 03/31/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8210 S LULU AVE
-----------------------------------------------------
City | HAYSVILLE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67060-7738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-899-3569
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8210 S LULU AVE
-----------------------------------------------------
City | HAYSVILLE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67060-7738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 53-85436-111
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------