Provider Demographics
NPI:1104382282
Name:CRAFT, KERI LYNN (MSN-FNP)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:LYNN
Last Name:CRAFT
Suffix:
Gender:F
Credentials:MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 W 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-5243
Mailing Address - Country:US
Mailing Address - Phone:903-874-5866
Mailing Address - Fax:903-874-5083
Practice Address - Street 1:219 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-5243
Practice Address - Country:US
Practice Address - Phone:903-874-5866
Practice Address - Fax:903-874-5083
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily