MEDICARE: MS. ALICE ELIZABETH KRAFT FNP-C

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	NP 572	AZ

General Provider Information

NPI Number	:	1588713952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALICE ELIZABETH KRAFT FNP-C

Provider Business Mailing Address
First Line	:	6509 N 13TH DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-1062
Country	:	US
Telephone Number	:	602-973-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	1002 E MCDOWELL RD # 120
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2625
Country	:	US
Telephone Number	:	602-256-2273
Fax Number	:	602-258-5618

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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