PHOENIX MEDICAL GROUP LLC NPI 1730834326

NPI Information

  • NPI: 1730834326
  • Provider Name: PHOENIX MEDICAL GROUP, LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 11357 NUCKOLS RD # 2091
    GLEN ALLEN, VA
    ZIP 23059
  • Phone: (804) 624-9917

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NPI Details

PHOENIX MEDICAL GROUP, LLC is a psychiatric/mental health nurse practitioner in Glen Allen, VA. PHOENIX MEDICAL GROUP, LLC NPI is 1730834326. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11357 NUCKOLS RD # 2091
GLEN ALLEN, VA
ZIP 23059-504
Phone: (804) 624-9917
Fax: (804) 729-5887

The provider's authorized official is Deborah Crutchfield .
The authorized official title is Dnp, Pmhnp-bc and has the following contact phone number (804) 965-4327.

The enumeration date for this NPI number is 2/13/2022 and was last updated on 8/25/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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