Provider Demographics
NPI:1841440583
Name:BERMUDEZ, CHRYSTAL LYNN (FNP)
Entity type:Individual
Prefix:MRS
First Name:CHRYSTAL
Middle Name:LYNN
Last Name:BERMUDEZ
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 1:9217 PARK WEST BLVD
Mailing Address - Street 2:SUITE C-3
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4404
Mailing Address - Country:US
Mailing Address - Phone:865-693-9373
Mailing Address - Fax:865-693-5368
Practice Address - Street 1:9217 PARK WEST BLVD
Practice Address - Street 2:SUITE C-3
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4404
Practice Address - Country:US
Practice Address - Phone:865-693-9373
Practice Address - Fax:865-693-5368
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13578363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily