Healthcare Provider Details

I. General information

NPI: 1043765019
Provider Name (Legal Business Name): BRANDI CRAIG CNM-APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 10/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 A ST
LINCOLN NE
68510-4299
US

IV. Provider business mailing address

9339 NORTHERN SKY RD
LINCOLN NE
68505-1002
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-3199
  • Fax:
Mailing address:
  • Phone: 402-363-1225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number73561
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number120068
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: