Crysil Dougherty, RN, BSN, PHN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

198393-5 Issued in MN

Practice address

2060 Centre Pointe Blvd Ste 3
Mendota Heights, MN 55120-1271

Phone

(612) 499-2260

NPI assigned

Aug 14, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1962058115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 CENTRE POINTE BLVD STE 3",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 CENTRE POINTE BLVD STE 3",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201271",
            "telephone_number": "612-499-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "CRYSIL",
        "credential": "RN, BSN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "198393-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jalen Denhartog
• Megan Deweese
• Andrea Dienslake
• Oliviah Marie Dmytrasz
• Enyonam Donkor
• Heidi Elizabeth Drechsel
• Stacy Dreelan, MS CCC-SLP
• Rebecca A Driscoll, RD
• Dungarvin Minnesota LLC
• Steven Dupic

• Registered Nurse in Mendota Heights, MN
• Providers in Mendota Heights, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.