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General NPI Number Information
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NPI Number | 1225617053
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Entity Type | Individual
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Provider Name | WENDY J CRAGE FNP
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Gender | Female
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 04/07/2021
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Provider Practice Location Address
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Address Line | 477 N EL CAMINO REAL
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City | ENCINITAS
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State | CA
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Zip | 92024-1328
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Country | US
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Telephone | 760-943-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 RUBENSTEIN DR
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City | CARDIFF BY THE SEA
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State | CA
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Zip | 92007-2319
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Country | US
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Telephone | 760-943-9111
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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 | 95016612
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License Number State | CA
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