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NPI Code Detail

MEDICARE: DEJA CRAYTON RN

MEDICARE:   DEJA  CRAYTON  RN
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
1163WM0705XMedical-Surgical Registered Nurse2822613AIN

General Provider Information

NPI Number : 1316730716
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEJA CRAYTON RN
Provider Business Mailing Address
First Line : 3546 HIGHWOODS DR N
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46222-1827
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3546 HIGHWOODS DR N
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46222-1827
Country : US
Telephone Number : 317-789-6457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2025
Last Update Date : 05/28/2025

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