Provider Demographics
NPI:1619111713
Name:CRAZE, LAURA LYNNE (APNP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LYNNE
Last Name:CRAZE
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:LYNNE
Other - Last Name:MCCAULEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:855 N WESTHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-7668
Mailing Address - Country:US
Mailing Address - Phone:920-456-7860
Mailing Address - Fax:920-456-7861
Practice Address - Street 1:855 N WESTHAVEN DR
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-7668
Practice Address - Country:US
Practice Address - Phone:920-456-7860
Practice Address - Fax:920-456-7860
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3707-033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner