Provider Demographics
NPI:1437814068
Name:CRISLER, ELI
Entity Type:Individual
Prefix:
First Name:ELI
Middle Name:
Last Name:CRISLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1647 MULBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-3705
Mailing Address - Country:US
Mailing Address - Phone:434-490-8053
Mailing Address - Fax:
Practice Address - Street 1:2611 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-1600
Practice Address - Country:US
Practice Address - Phone:540-221-6702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024183073207NS0135X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology