=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609744259
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CRYSTAL LYNN CROSMAN CRNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2025
-----------------------------------------------------
Last Update Date | 10/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 37 COLONIAL DR
-----------------------------------------------------
City | HANOVER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17331-9371
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-965-0841
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 37 COLONIAL DR
-----------------------------------------------------
City | HANOVER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17331-9371
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | SP033631
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------