MEDICARE: KYLE LYNN CRAVER PA-C

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	171000000X	Military Health Care Provider	7529	AZ
2	363A00000X	Physician Assistant	7529	AZ
3	363A00000X	Physician Assistant	001015267	NC

General Provider Information

NPI Number	:	1760956387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE LYNN CRAVER PA-C

Provider Business Mailing Address
First Line	:	1542 ANTIOCH DR
Second Line	:
City	:	CONOVER
State	:	NC
Zip	:	28613-9267
Country	:	US
Telephone Number	:	336-239-1464
Fax Number	:

Provider Business Practice Location Address
First Line	:	2874 S NC 127 HWY
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-9131
Country	:	US
Telephone Number	:	828-294-4100
Fax Number	:	800-951-8614

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

Provider Enumeration Date	:	01/16/2019
Last Update Date	:	08/26/2025

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