Provider Demographics
NPI:1336893999
Name:CRAVER, MICHELLE RENEE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEE
Last Name:CRAVER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MISTLETOE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4048
Mailing Address - Country:US
Mailing Address - Phone:817-338-1300
Mailing Address - Fax:682-747-5141
Practice Address - Street 1:1900 MISTLETOE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4048
Practice Address - Country:US
Practice Address - Phone:817-338-1300
Practice Address - Fax:682-747-5141
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1070389363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care