Individual provider · Type 1 NPI
Krystal Annie Bodily, FNP
Family Nurse Practitioner · Santa Rosa, CA
NPI number
1912463407
Active
Practice location
751 Lombardi Ct
Santa Rosa, CA 95407-6798
Mailing address
2657 Bailey Ct
Fremont, CA 94536-5304
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 95011099 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1912463407
Krystal Annie Bodily, FNP's National Provider Identifier is 1912463407, issued on Feb 20, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Santa Rosa, CA. The record was last updated on Oct 24, 2025.