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General NPI Number Information
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NPI Number | 1477201788
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Entity Type | Individual
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Provider Name | HALEY N DRAGOO-KRASKOVIC FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 19026 RIDGEWOOD PKWY STE 119
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City | SAN ANTONIO
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State | TX
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Zip | 78259-5500
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Country | US
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Telephone | 720-862-8883
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Fax |
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Provider Business Mailing Address
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Address Line | 19026 RIDGEWOOD PKWY STE 119
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City | SAN ANTONIO
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State | TX
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Zip | 78259-5500
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Country | US
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Telephone | 720-862-8883
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1073048
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License Number State | TX
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