Healthcare Provider Details

I. General information

NPI: 1447613278
Provider Name (Legal Business Name): DANIELLE CRAIG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 SE 2ND ST STE B
LEES SUMMIT MO
64063-2629
US

IV. Provider business mailing address

517 SE 2ND ST STE B
LEES SUMMIT MO
64063-2629
US

V. Phone/Fax

Practice location:
  • Phone: 816-327-2305
  • Fax: 816-207-0481
Mailing address:
  • Phone: 816-327-2305
  • Fax: 816-207-0481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9408862
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: