Provider Demographics
NPI:1487324331
Name:CRAVEN, YVETTE A
Entity type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:A
Last Name:CRAVEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 FAWN DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-6100
Mailing Address - Country:US
Mailing Address - Phone:513-557-8150
Mailing Address - Fax:513-795-7153
Practice Address - Street 1:63 FAWN DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-6100
Practice Address - Country:US
Practice Address - Phone:513-557-8150
Practice Address - Fax:513-795-7153
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3107659172A00000X, 253Z00000X, 3747P1801X, 385HR2050X, 376J00000X
385HR2050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver
No253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp