Provider Demographics
NPI:1770444218
Name:KENNETH CRAFT - A NURSING CORPORATION
Entity type:Organization
Organization Name:KENNETH CRAFT - A NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:775-400-6617
Mailing Address - Street 1:6483 WATT AVE UNIT 144
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-2005
Mailing Address - Country:US
Mailing Address - Phone:775-400-6617
Mailing Address - Fax:775-418-6100
Practice Address - Street 1:6483 WATT AVE UNIT 144
Practice Address - Street 2:
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-2005
Practice Address - Country:US
Practice Address - Phone:775-400-6617
Practice Address - Fax:775-418-6100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty