Healthcare Provider Details

I. General information

NPI: 1497591424
Provider Name (Legal Business Name): ALEXANDRIA K CRAIG CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRIA K KNIGGE CRNP

II. Dates (important events)

Enumeration Date: 07/09/2024
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 626
RUSSELLVILLE AL
35653-0626
US

IV. Provider business mailing address

PO BOX 626
RUSSELLVILLE AL
35653-0626
US

V. Phone/Fax

Practice location:
  • Phone: 256-332-6208
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-176293
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: