Healthcare Provider Details

I. General information

NPI: 1225414105
Provider Name (Legal Business Name): ALICIA J CRAFA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ALICIA J BENGTSON

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 N NEVADA AVE
COLORADO SPRINGS CO
80907-6819
US

IV. Provider business mailing address

PO BOX 800022
KANSAS CITY MO
64180-0022
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-3580
  • Fax: 719-776-8050
Mailing address:
  • Phone: 800-953-0104
  • Fax: 303-765-6670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0991832
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0991832-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: