Organization
IMPACT PRACTITIONER SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI KRAAZ AAPRN (SOLE PROPIETOR)
(772) 528-5991
Entity
Organization
Contact information
Practice address
3307 N INDIAN RIVER DR, FORT PIERCE, FL 34946-8418
(772) 528-5991
Mailing address
3307 N INDIAN RIVER DR, FORT PIERCE, FL 34946-8418
(772) 528-5991
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/09/2024
Last updated
04/09/2024
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