Provider Demographics
NPI:1174541254
Name:CRAIG, KACEY ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:KACEY
Middle Name:ANN
Last Name:CRAIG
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Mailing Address - Street 1:9330 S UNIVERSITY BLVD
Mailing Address - Street 2:SUITE #250
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-5065
Mailing Address - Country:US
Mailing Address - Phone:303-346-7777
Mailing Address - Fax:303-346-7778
Practice Address - Street 1:9330 S UNIVERSITY BLVD
Practice Address - Street 2:SUITE #250
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-5065
Practice Address - Country:US
Practice Address - Phone:303-346-7777
Practice Address - Fax:303-346-7778
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CORN-118944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily