Provider Demographics
NPI:1558879510
Name:CRAFT, ELAINE ALBA (BSN, RN, CPN)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:ALBA
Last Name:CRAFT
Suffix:
Gender:F
Credentials:BSN, RN, CPN
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Other - First Name:
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Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6063
Mailing Address - Fax:904-539-4091
Practice Address - Street 1:4511 N DAVIS HWY STE C
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2734
Practice Address - Country:US
Practice Address - Phone:850-416-1950
Practice Address - Fax:850-416-1951
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11012656363L00000X
FL94134382080P0216X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology