Provider Demographics
NPI:1144937707
Name:CRAFT, WANDA KRISTIN (MSN, CRNP, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:KRISTIN
Last Name:CRAFT
Suffix:
Gender:F
Credentials:MSN, CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9722 BOX RD
Mailing Address - Street 2:
Mailing Address - City:SEMMES
Mailing Address - State:AL
Mailing Address - Zip Code:36575-8908
Mailing Address - Country:US
Mailing Address - Phone:251-680-7168
Mailing Address - Fax:
Practice Address - Street 1:3715 DAUPHIN STREET
Practice Address - Street 2:BLDG. 2 SUITE 503-B
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608
Practice Address - Country:US
Practice Address - Phone:251-263-5669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-127043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily