Healthcare Provider Details

I. General information

NPI: 1407389232
Provider Name (Legal Business Name): CHRISTEN MAE CRAIG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2017
Last Update Date: 04/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6675 HOLMES RD STE 430
KANSAS CITY MO
64131-1167
US

IV. Provider business mailing address

6675 HOLMES RD STE 430
KANSAS CITY MO
64131-1167
US

V. Phone/Fax

Practice location:
  • Phone: 816-361-0055
  • Fax: 816-361-5775
Mailing address:
  • Phone: 816-361-0055
  • Fax: 816-361-5775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017007334
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: