Doctor Name: | CRYSTAL K BLOSSER |
NPI Number: | 1225375520 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | 0024170509 |
Business Practice Address: | 2006 Health Campus Dr Medical Office Building, 3rd Floor Rockingham, VA - 228018679 |
Business Phone Number: | 5406894139 |
Business Fax Number: | 5406894131 |
Mailing Address: | 2006 Health Campus Dr, Medical Office Building, 3rd Floor ROCKINGHAM |
State: | VA |
Postal Code: | 228018679 |
Phone Number: | 5406894139 |
Fax Number: | 5406894131 |
NPI Enumeration Date: | 01/08/2013 |
NPI Last Update Date: | 07/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 0024170509 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |