Healthcare Provider Details

I. General information

NPI: 1558654152
Provider Name (Legal Business Name): HEIDI M KRAFT MSN, CNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 WATER ST
FITCHBURG MA
01420-5747
US

IV. Provider business mailing address

PO BOX 1055
GREENVILLE NH
03048-1055
US

V. Phone/Fax

Practice location:
  • Phone: 978-878-8100
  • Fax:
Mailing address:
  • Phone: 774-225-0075
  • Fax: 978-878-8535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN264523
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number079140-23
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN264523
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: