KRYSTAL ANNIE BODILY FNP
NPI 1912463407
Nurse Practitioner - Family in Santa Rosa, CA
About Krystal Annie Bodily Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KRYSTAL ANNIE BODILY FNP (NPI 1912463407) is an individual family provider in Santa Rosa, California, licensed in California (95011099) and active in the NPI registry since February 2019.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SANTA ROSA, CA 95407
SANTA ROSA, CA 95407
SANTA ROSA, CA 95407
SANTA ROSA, CA 95407
SANTA ROSA, CA 95407
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Krystal Bodily's NPI number?
The NPI number for Krystal Bodily is 1912463407. It was assigned to this individual provider in the NPPES registry on February 20, 2019.
Where is Krystal Bodily located?
Krystal Bodily practices at 751 Lombardi Ct, Santa Rosa, CA 95407. The listed phone number is (707) 547-2222.
What is Krystal Bodily's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
When was this NPI record last updated?
The NPPES record for Krystal Bodily was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Krystal Annie Bodily, FNP · NPI 1912463407
Family physician in Santa Rosa, California. Individual provider, active in the CMS NPPES registry since February 20, 2019.
## Identity
- **NPI:** 1912463407 (Entity type: Individual)
- **Enumerated:** February 20, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 95011099 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 751 LOMBARDI CT, Santa Rosa, CA 95407-6798
- **Phone:** (707) 547-2222
## Record status
- **NPPES last updated:** October 24, 2025
- **Other identifiers:** Other 95011099 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1912463407) · Data from the CMS NPPES public registry.