Individual
KENNETH LEE CRAFT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
150 COUNTRY ESTATES CIR STE 111, RENO, NV 89511-4017
(775) 400-6617
(775) 418-6100
Mailing address
3983 S MCCARRAN BLVD # 703, RENO, NV 89502-7510
(775) 400-6617
(775) 418-6100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
726633
CA
163WC1600X
Continuing Education/Staff Development Registered Nurse
726633
CA
363LF0000X
Family Nurse Practitioner
Primary
001840
NV
363LF0000X
Family Nurse Practitioner
22618
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100539957
—
NV
Enumeration date
11/30/2012
Last updated
06/26/2024
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