Provider Demographics
NPI:1205391489
Name:BURNSBY, CRYSTAL MARIA (FNP)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:MARIA
Last Name:BURNSBY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:MARIA
Other - Last Name:BURNSBY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3768 STATE HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-6502
Mailing Address - Country:US
Mailing Address - Phone:518-883-3121
Mailing Address - Fax:
Practice Address - Street 1:3768 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-6502
Practice Address - Country:US
Practice Address - Phone:518-883-3121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF351063-01363LF0000X
NY716728163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool