Provider Demographics
NPI:1467020347
Name:CRAZE, MADISON SUZANNA
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:SUZANNA
Last Name:CRAZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-1105
Mailing Address - Country:US
Mailing Address - Phone:586-713-9718
Mailing Address - Fax:
Practice Address - Street 1:940 JOHN ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-2857
Practice Address - Country:US
Practice Address - Phone:269-343-7296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant