Provider Demographics
NPI:1679200760
Name:CRATER, DENYS (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DENYS
Middle Name:
Last Name:CRATER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 RIVERBOAT CENTER DR
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-9341
Mailing Address - Country:US
Mailing Address - Phone:815-409-4930
Mailing Address - Fax:815-741-3263
Practice Address - Street 1:1541 RIVERBOAT CENTER DR
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431-9341
Practice Address - Country:US
Practice Address - Phone:815-409-4930
Practice Address - Fax:815-741-3263
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209025650363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily