Provider Demographics
NPI:1235649674
Name:CROSBIE, RYNTHIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:RYNTHIA
Middle Name:
Last Name:CROSBIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3451 S 5600 W STE 5
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-1301
Mailing Address - Country:US
Mailing Address - Phone:801-957-0900
Mailing Address - Fax:801-966-4384
Practice Address - Street 1:3451 S 5600 W STE 5
Practice Address - Street 2:
Practice Address - City:WEST VALLEY
Practice Address - State:UT
Practice Address - Zip Code:84120-1301
Practice Address - Country:US
Practice Address - Phone:801-957-0900
Practice Address - Fax:801-966-4384
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6855746-4405363LP0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics