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General NPI Number Information
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NPI Number | 1003275157
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Entity Type | Individual
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Provider Name | KELLI KRAAZ ARNP- FNP
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Gender | Female
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Dates
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Enumeration Date | 02/17/2016
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 3307 N INDIAN RIVER DR
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City | FORT PIERCE
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State | FL
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Zip | 34946-8418
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Country | US
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Telephone | 772-528-5991
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Fax |
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Provider Business Mailing Address
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Address Line | 3307 N INDIAN RIVER DR
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City | FORT PIERCE
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State | FL
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Zip | 34946-8418
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Country | US
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Telephone | 772-528-5991
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN2165662
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN 2165662
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License Number State | FL
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