Healthcare Provider Details

I. General information

NPI: 1972629269
Provider Name (Legal Business Name): KARRIE ANN CRAVENS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 W SPEEDWAY BLVD STE 100
TUCSON AZ
85705-7687
US

IV. Provider business mailing address

4980 N CAMINO ANTONIO
TUCSON AZ
85718-6006
US

V. Phone/Fax

Practice location:
  • Phone: 520-628-7871
  • Fax: 520-205-8461
Mailing address:
  • Phone: 520-628-7871
  • Fax: 520-205-8461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN050573
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: