Look up the most recent NPI and PECOS records

Chrystal Craft

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2801 W Kinnickinnic River Pkwy Ste 380, Milwaukee, WI 53215-3632

PECOS Enrollment

Based on the most recent information from CMS, provider Chrystal Craft is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1679194278
Provider Type
Individual
Full Name
Craft, Chrystal
Credential
APNP

Gender
Female
Sole Proprietor
No
Enumeration Date
5/5/2020
Last Updated
5/12/2025

Contact Information

Practice Location

2801 W Kinnickinnic River Pkwy Ste 380, Milwaukee, WI 53215-3632

(414) 649-3370

Unlisted Fax

Mailing Location

PO Box 735044, Chicago, IL 60673-5044

(800) 326-2250

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 10182 Wisconsin
Code 363LA2100X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 10182 Wisconsin

Provider Identifiers

ID	Description	Issuer
ID 100101286	Description Medicaid	Issuer Unlisted Wisconsin

Chrystal Craft

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Mattes, Elizabeth

Konkel, Lauren K

Fisher, Rachel M

Hourani, Lama R

Heppe, Megan M

Sarandos, Maria T

Cohn, Casey L.

Buchaklian, Celeste Miranda

Thomas, Michael B

Maney, Kristen M