Provider Demographics
NPI:1043975444
Name:CRAFT, MICHELLE ANNE (APRN-RNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANNE
Last Name:CRAFT
Suffix:
Gender:F
Credentials:APRN-RNP, FNP-BC
Other - Prefix:
Other - First Name:MISSY
Other - Middle Name:ANNE
Other - Last Name:CRAFT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN-RNP, FNP-BC
Mailing Address - Street 1:14130 N SPOTTED EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7904
Mailing Address - Country:US
Mailing Address - Phone:928-499-4607
Mailing Address - Fax:
Practice Address - Street 1:5860 S HOSPITAL DR STE 102
Practice Address - Street 2:
Practice Address - City:GLOBE
Practice Address - State:AZ
Practice Address - Zip Code:85501-9449
Practice Address - Country:US
Practice Address - Phone:928-402-0491
Practice Address - Fax:928-402-0490
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ262799363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily