Provider Demographics
NPI:1225414105
Name:CRAFA, ALICIA J (FNP)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:J
Last Name:CRAFA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:ALICIA
Other - Middle Name:J
Other - Last Name:BENGTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 800022
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-0022
Mailing Address - Country:US
Mailing Address - Phone:800-953-0104
Mailing Address - Fax:303-765-6670
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6819
Practice Address - Country:US
Practice Address - Phone:719-776-3580
Practice Address - Fax:719-776-8050
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0991832363LF0000X
COAPN.0991832-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO50720058Medicaid