MEDICARE: JOAN MCCRAW MSN, FNP, APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN00386	NV
2	363LF0000X	Family Nurse Practitioner	APRN00386	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053336784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN MCCRAW MSN, FNP, APRN

Provider Business Mailing Address
First Line	:	5530 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-0566
Country	:	US
Telephone Number	:	702-341-0311
Fax Number	:	702-254-1621

Provider Business Practice Location Address
First Line	:	5530 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118
Country	:	US
Telephone Number	:	702-341-0311
Fax Number	:	702-254-1621

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	08/23/2019

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