MEDICARE: MRS. KACEY ANN CRAIG N.P.

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
1	363LF0000X	Family Nurse Practitioner	RN-118944	CO

General Provider Information

NPI Number	:	1174541254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KACEY ANN CRAIG N.P.

Provider Business Mailing Address
First Line	:	9330 S UNIVERSITY BLVD
Second Line	:	SUITE #250
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-5065
Country	:	US
Telephone Number	:	303-346-7777
Fax Number	:	303-346-7778

Provider Business Practice Location Address
First Line	:	9330 S UNIVERSITY BLVD
Second Line	:	SUITE #250
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80126-5065
Country	:	US
Telephone Number	:	303-346-7777
Fax Number	:	303-346-7778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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