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NPI Code Detail

MEDICARE: TERRI LYNN KRAFT NP

MEDICARE: TERRI LYNN KRAFT NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse4704154586MI
2363LA2100XAcute Care Nurse Practitioner4704154586MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14704154586OTHERMICONTROLLED SUBSTANCE

General Provider Information

NPI Number : 1043295603
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRI LYNN KRAFT NP
Provider Business Mailing Address
First Line : 333 COMMERCE ST STE 700
Second Line :
City : NASHVILLE
State : TN
Zip : 37201-1835
Country : US
Telephone Number : 615-454-9850
Fax Number : 855-737-5542
Provider Business Practice Location Address
First Line : 250 MONROE AVE NW STE 400
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2293
Country : US
Telephone Number : 877-702-6863
Fax Number : 855-737-5542
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 04/27/2018

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