Individual
JENNIFER CRAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5414 S BROADWAY AVE, TYLER, TX 75703-1335
(903) 581-1601
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP127957
TX
363LF0000X
Family Nurse Practitioner
AP127957
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355528604
—
TX
05
—
355528605
—
TX
05
—
355528606
—
TX
05
—
355528607
—
TX
01
—
75-0818167-015
TRICARE
TX
01
—
75-0818167-044
TRICARE
TX
01
—
75-1976930-005
TRICARE
TX
01
—
75-2616977-001
TRICARE
TX
01
—
75-2616977-002
TRICARE
TX
01
—
75-2616977-028
TRICARE
TX
01
—
8GF850
BCBS
TX
01
—
8GF851
BCBS
TX
01
—
8GF852
BCBS
TX
01
—
8GF853
BCBS
TX
01
—
P01754646
RAIL ROAD MEDICARE
TX
01
—
P01782063
RAIL ROAD MEDICARE
TX
Enumeration date
04/16/2015
Last updated
04/18/2023
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