MEDICARE: MISS MADISON CRAVER

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	363A00000X	Physician Assistant	PA.0006182	CO

General Provider Information

NPI Number	:	1255966016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MADISON CRAVER

Provider Business Mailing Address
First Line	:	4481 TULE LAKE DR
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80123-2745
Country	:	US
Telephone Number	:	303-514-5380
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 E HAMPDEN AVE
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80113-2795
Country	:	US
Telephone Number	:	303-788-5000
Fax Number	:

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

Provider Enumeration Date	:	03/11/2020
Last Update Date	:	03/11/2020

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Directions to “ MISS MADISON CRAVER ” Practice Location

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