Provider Demographics
NPI:1396181624
Name:CRAFT, TANYA LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:TANYA
Middle Name:LYNN
Last Name:CRAFT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8008 BLUEBONNET BLVD
Mailing Address - Street 2:APT 11-14
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-7800
Mailing Address - Country:US
Mailing Address - Phone:601-392-9112
Mailing Address - Fax:
Practice Address - Street 1:8008 BLUEBONNET BLVD
Practice Address - Street 2:APT 11-14
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-7800
Practice Address - Country:US
Practice Address - Phone:601-392-9112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN049586163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse