MEDICARE: SHAWNTA CRAYTON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F08190058	IN

General Provider Information

NPI Number	:	1023651072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWNTA CRAYTON NP

Provider Business Mailing Address
First Line	:	10721 CRELL CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-9770
Country	:	US
Telephone Number	:	317-680-5402
Fax Number	:	949-882-0475

Provider Business Practice Location Address
First Line	:	10721 CRELL CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-9770
Country	:	US
Telephone Number	:	317-680-5402
Fax Number	:	949-882-0475

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2019
Last Update Date	:	05/21/2026

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