Chrystal Chan Talley

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R191639 Issued in MD

Practice address

3901 The Alameda
Baltimore, MD 21218-2100

Phone

(410) 605-7000

NPI assigned

Feb 26, 2024

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

Other names 1

• Chrystal Chan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1992561146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 TURNBULL RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211333308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 THE ALAMEDA",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182100",
            "telephone_number": "410-605-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN TALLEY",
        "first_name": "CHRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R191639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRYSTAL",
            "last_name": "CHAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ann-Marie D Champ, P.T.
• Kathryn Graham Champ, MD
• Champion Emergency Physicians LLC
• Elizabeth C Champney, LCSWC
• Zuzana Chamrova, M.D.
• Kirk Maurice Chan-Tack, M.D.
• Amanda Y Chan, PHARM.D.
• Caleb C. Chan, M.D.
• Christine Chan, DO
• Danielle Chan

• Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.