Chrysalis Wellness, PLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

CHRYSALIS WELLNESS, PLC

Practice address

302 Chestnut St Ste 408
Virginia, MN 55792-5610

Phone

(218) 969-7824

NPI assigned

Aug 18, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chandra Lynn White, APRN, CNP

Title

Owner

Phone

(218) 969-0386

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1083497358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PRESIDENT AVE # 701",
            "city": "BUHL",
            "state": "MN",
            "postal_code": "557134451",
            "telephone_number": "218-969-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CHESTNUT ST STE 408",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557925610",
            "telephone_number": "218-969-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS WELLNESS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CHANDRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-969-0386",
        "authorized_official_credential": "APRN, CNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary R Champa, RN
• Charles a Tietz MD Facog LTD
• Frederick Nji Chomilo, PHARMD
• Christian Neurology Associates of Minnesota, PA
• Christine Ann Christie, O.D.
• Allee Marie Chyrklund
• Frederick Cina, DDS
• City of Virginia
• Amanda Claesson, MOTR/L
• Amy L Clark

• All providers in Virginia, MN
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.