Healthcare Provider Details

I. General information

NPI: 1629751789
Provider Name (Legal Business Name): DIANE LYNNE KRAFFT PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 FULTON GREER RD
FRANKLIN TN
37064-2296
US

IV. Provider business mailing address

3205 NOLEN LN
FRANKLIN TN
37064-6222
US

V. Phone/Fax

Practice location:
  • Phone: 615-592-3003
  • Fax:
Mailing address:
  • Phone: 813-390-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number7305
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: