Provider Demographics
NPI:1306023981
Name:CRAYTON, TRACI JANELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRACI
Middle Name:JANELLE
Last Name:CRAYTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14470 MILLHOPPER RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-3128
Mailing Address - Country:US
Mailing Address - Phone:850-559-0066
Mailing Address - Fax:904-886-4528
Practice Address - Street 1:14470 MILLHOPPER RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-3128
Practice Address - Country:US
Practice Address - Phone:850-559-0066
Practice Address - Fax:904-886-4528
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-26
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist