Provider Demographics
NPI:1083953061
Name:CRAFT, JENNY MARIE (RN, FCP)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:MARIE
Last Name:CRAFT
Suffix:
Gender:F
Credentials:RN, FCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3179 NOTRE DAME DR
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-2733
Mailing Address - Country:US
Mailing Address - Phone:850-221-2052
Mailing Address - Fax:
Practice Address - Street 1:3179 NOTRE DAME DR
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-2733
Practice Address - Country:US
Practice Address - Phone:850-221-2052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator