Provider Demographics
NPI:1700611597
Name:KRAFT, ANN MELINDA (MSN APRN PMHNP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MELINDA
Last Name:KRAFT
Suffix:
Gender:F
Credentials:MSN APRN PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 OPENING HILL RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-1944
Mailing Address - Country:US
Mailing Address - Phone:203-909-3141
Mailing Address - Fax:
Practice Address - Street 1:474 OPENING HILL RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-1944
Practice Address - Country:US
Practice Address - Phone:203-909-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13954363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health