Provider Demographics
NPI:1346597663
Name:STALEY, CHYRISSA ROSANNA (FNP)
Entity Type:Individual
Prefix:
First Name:CHYRISSA
Middle Name:ROSANNA
Last Name:STALEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 FRONTIER
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-5942
Mailing Address - Country:US
Mailing Address - Phone:713-447-4990
Mailing Address - Fax:
Practice Address - Street 1:717 GENERATIONS DR STE B
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-0009
Practice Address - Country:US
Practice Address - Phone:844-789-7246
Practice Address - Fax:888-880-9323
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP122247363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX259417YK8CMedicare UPIN