Basic Information
Provider Information
NPI: 1295203271
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CRAFTON
FirstName: LORNA
MiddleName: D
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 5801 S MCCLINTOCK DR STE 110
Address2:  
City: TEMPE
State: AZ
PostalCode: 852836002
CountryCode: US
TelephoneNumber: 4807770607
FaxNumber:  
Practice Location
Address1: 31330 SCHOOLCRAFT RD STE 200
Address2:  
City: LIVONIA
State: MI
PostalCode: 481502042
CountryCode: US
TelephoneNumber: 7345259712
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/07/2018
LastUpdateDate: 11/07/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
246Z00000X  Y Technologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other 

No ID Information.


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