Provider Demographics
NPI:1629751789
Name:KRAFFT, DIANE LYNNE (PTA)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:LYNNE
Last Name:KRAFFT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 NOLEN LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-6222
Mailing Address - Country:US
Mailing Address - Phone:813-390-8994
Mailing Address - Fax:
Practice Address - Street 1:1035 FULTON GREER RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-2296
Practice Address - Country:US
Practice Address - Phone:615-592-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7305208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation