Crystal Annette Rydalch, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61171748 Issued in WA

Practice address

55 N Wolfe Ave
Edwards AFB, CA 93524-2227

Phone

(616) 277-7118

NPI assigned

May 28, 2018

Last updated

Apr 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Crystal Annette Chatfield Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1527465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1639660418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 N WOLFE AVE",
            "city": "EDWARDS AFB",
            "state": "CA",
            "postal_code": "935246201",
            "telephone_number": "661-277-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N WOLFE AVE",
            "city": "EDWARDS AFB",
            "state": "CA",
            "postal_code": "935242227",
            "telephone_number": "616-277-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDALCH",
        "first_name": "CRYSTAL",
        "middle_name": "ANNETTE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-28",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.018127",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61171748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "CHATFIELD",
            "middle_name": "ANNETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lee Paschen
• Piotr Wojciech Podlesny, M.D.
• Brandon John Potters, IDC
• Alicia Raschke
• Joel David Reyes, PA-C
• Jerel Devere Scarberry, M.D.
• Donna N. Sewell, LCSW
• Jordan Lee Simonson, PHD
• Cynthia F Siqueiros
• Richard Lee Stahlman, M.D.

• Family Nurse Practitioner in Edwards AFB, CA
• Providers in Edwards AFB, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.