Provider Demographics
NPI:1225375520
Name:BLOSSER, CRYSTAL K (NP-C)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:K
Last Name:BLOSSER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 HEALTH CAMPUS DR
Mailing Address - Street 2:MEDICAL OFFICE BUILDING, 3RD FLOOR
Mailing Address - City:ROCKINGHAM
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8679
Mailing Address - Country:US
Mailing Address - Phone:540-689-4139
Mailing Address - Fax:540-689-4131
Practice Address - Street 1:2006 HEALTH CAMPUS DR
Practice Address - Street 2:MEDICAL OFFICE BUILDING, 3RD FLOOR
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-8679
Practice Address - Country:US
Practice Address - Phone:540-689-4139
Practice Address - Fax:540-689-4131
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily