Provider Demographics
NPI:1922560432
Name:BROMLEY, CRYSTAL DISE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:DISE
Last Name:BROMLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-4921
Mailing Address - Country:US
Mailing Address - Phone:410-742-3784
Mailing Address - Fax:410-543-6918
Practice Address - Street 1:108 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4921
Practice Address - Country:US
Practice Address - Phone:410-742-3784
Practice Address - Fax:410-543-6918
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR118394163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health