Provider Demographics
NPI:1275883365
Name:CRAVER, MICHELLE MARIE (APN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:CRAVER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8745 COUNTY ROAD 9 SOUTH
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101
Mailing Address - Country:US
Mailing Address - Phone:719-587-4593
Mailing Address - Fax:719-587-5699
Practice Address - Street 1:8745 COUNTY ROAD 9 SOUTH
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101
Practice Address - Country:US
Practice Address - Phone:719-587-4593
Practice Address - Fax:719-587-5699
Is Sole Proprietor?:No
Enumeration Date:2012-09-15
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7534101YA0400X
CO167693163W00000X
COAPN.0991151-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner