Provider Demographics
NPI:1144867482
Name:CRAFT, TERRINNE ELAINE (NP)
Entity type:Individual
Prefix:MRS
First Name:TERRINNE
Middle Name:ELAINE
Last Name:CRAFT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:TERRINE
Other - Middle Name:ELAINE
Other - Last Name:TOWNSEND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5224 S STATE HIGHWAY 360
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0950
Mailing Address - Country:US
Mailing Address - Phone:972-522-0691
Mailing Address - Fax:972-522-1053
Practice Address - Street 1:5224 S STATE HIGHWAY 360
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-0950
Practice Address - Country:US
Practice Address - Phone:972-522-0691
Practice Address - Fax:972-522-1053
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32476363LF0000X
TXAP144018363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF10190529OtherAANPCB NUMBER