Provider Demographics
NPI:1649547571
Name:DORSEY, CHRYSTAL KENISHA (RN, MSN, ANP-BC)
Entity type:Individual
Prefix:MS
First Name:CHRYSTAL
Middle Name:KENISHA
Last Name:DORSEY
Suffix:
Gender:F
Credentials:RN, MSN, ANP-BC
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Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:101 BURRS RD STE C
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-5517
Practice Address - Country:US
Practice Address - Phone:609-702-7550
Practice Address - Fax:609-702-1277
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2023-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00336700363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0281794Medicaid
NJ234452OtherMEDICARE