Active NPI
Krystal Lynn Self, PHARM. D.
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Suffolk, VA
National Provider Identifier
1376847608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 0202208263
- Practice address
- 1017 University Blvd
Suffolk, VA 23435-0048 - Phone
- (757) 335-4537
- NPI assigned
- Dec 30, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 0202208263 | VA | Primary |
Addresses
Primary practice location
1017 University Blvd
Suffolk, VA 23435-0048
Mailing address
1356 Gaskins Rd
Henrico, VA 23238-4919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202208263 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782172800000",
"number": "1376847608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1356 GASKINS RD",
"city": "HENRICO",
"state": "VA",
"postal_code": "232384919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 UNIVERSITY BLVD",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234350048",
"telephone_number": "757-335-4537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELF",
"first_name": "KRYSTAL",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHARM. D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-30",
"last_updated": "2026-06-23",
"certification_date": "2026-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "VA",
"license": "0202208263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.