Healthcare Provider Details

I. General information

NPI: 1790517563
Provider Name (Legal Business Name): JULIE FRANTZ CRAVEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9880 ANGIES WAY STE 250
LOUISVILLE KY
40241-2865
US

IV. Provider business mailing address

PO BOX 776351
CHICAGO IL
60677-6351
US

V. Phone/Fax

Practice location:
  • Phone: 502-394-6341
  • Fax:
Mailing address:
  • Phone: 502-588-9490
  • Fax: 502-272-5116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4016641
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: