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General NPI Number Information
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NPI Number | 1326453622
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Entity Type | Individual
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Provider Name | VICKY CRAIG APRN
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Gender | Female
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Dates
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Enumeration Date | 06/25/2014
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 107 W COLLEGE AVE
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City | HARTSVILLE
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State | SC
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Zip | 29550-4113
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Country | US
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Telephone | 843-951-0053
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Fax | 843-951-0054
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Provider Business Mailing Address
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Address Line | 107 W COLLEGE AVE
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City | HARTSVILLE
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State | SC
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Zip | 29550-4113
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Country | US
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Telephone | 843-951-0053
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Fax | 843-951-0054
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 103438
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 18903
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License Number State | SC
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