Crystal Annette Rydalch, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Edwards Afb, CA
NPI 1639660418 · NPPES record last updated Apr 13, 2023
Key facts
- NPI
- 1639660418
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP61171748 (WA)
- Practice address
- 55 N Wolfe Ave
Edwards Afb, CA 93524-2227 - Phone
- (616) 277-7118
- NPI assigned
- May 28, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201203001091 | GA | Order and Referring Only - Nurse Practitioner | 1658782230 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.018127 | IL | MD | Family Nurse Practitioner |
| AP61171748 | WA | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.018127 | IL | |
| Family Nurse Practitioner | 363LF0000X | AP61171748 | WA | Yes |
Addresses
Primary practice location
55 N Wolfe Ave
Edwards Afb, CA 93524-2227
Mailing address
55 N Wolfe Ave
Edwards Afb, CA 93524-6201
Phone (661) 277-7118
Other names
- Crystal Annette Chatfield
Other providers in Edwards Afb, CA
- Lee Paschen
- Piotr Wojciech Podlesny
- Brandon John Potters
- Alicia Raschke
- Joel David Reyes
- Jerel Devere Scarberry
- Donna N. Sewell
- Jordan Lee Simonson
- Cynthia F Siqueiros
- Richard Lee Stahlman
All providers in Edwards Afb, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.