Healthcare Provider Details

I. General information

NPI: 1770669756
Provider Name (Legal Business Name): CHERYL ANNE CRAIG MA, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 WEST UPPER FERRY ROAD
EWING NJ
08628-2717
US

IV. Provider business mailing address

45 WEST UPPER FERRY ROAD
EWING NJ
08628-2717
US

V. Phone/Fax

Practice location:
  • Phone: 609-882-5128
  • Fax:
Mailing address:
  • Phone: 609-882-5128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number26NR11650700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: