Provider Demographics
NPI:1992150684
Name:HARRIS, CRYSTAL D (NP-C)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:D
Last Name:HARRIS
Suffix:
Gender:
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W CORK ST UNIT 405
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3876
Mailing Address - Country:US
Mailing Address - Phone:540-313-9200
Mailing Address - Fax:540-686-7287
Practice Address - Street 1:333 W CORK ST UNIT 405
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3876
Practice Address - Country:US
Practice Address - Phone:540-313-9200
Practice Address - Fax:540-686-7287
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173510363L00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner