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General NPI Number Information
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NPI Number | 1932681947
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Entity Type | Individual
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Provider Name | CRYSTAL ALEXANDER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/06/2018
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 3660 BOULEVARD E
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834
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Country | US
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Telephone | 804-805-8704
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 POOR HOUSE RD
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City | LAWRENCEVILLE
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State | VA
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Zip | 23868-2712
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Country | US
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Telephone | 434-229-8690
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024175640
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License Number State | VA
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