Provider Demographics
NPI:1780437590
Name:CROSBY, FALYN NICHOLE (ARNP)
Entity type:Individual
Prefix:
First Name:FALYN
Middle Name:NICHOLE
Last Name:CROSBY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:FALYN
Other - Middle Name:NICHOLE
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16632 KATO LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-7103
Mailing Address - Country:US
Mailing Address - Phone:360-391-7169
Mailing Address - Fax:
Practice Address - Street 1:16632 KATO LN
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-7103
Practice Address - Country:US
Practice Address - Phone:360-391-7169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61540990363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health