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General NPI Number Information
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NPI Number | 1508263013
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Entity Type | Individual
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Provider Name | CRAIG ADRIAN HEADLEY NP
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Gender | Male
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Dates
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Enumeration Date | 11/26/2014
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 5 CORNWALL LN APT 2X
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City | CARLE PLACE
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State | NY
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Zip | 11514-1083
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Country | US
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Telephone | 516-294-1728
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Fax |
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Provider Business Mailing Address
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Address Line | 5 CORNWALL LN APT 2X
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City | CARLE PLACE
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State | NY
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Zip | 11514-1083
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Country | US
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Telephone |
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F401722
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 7761377
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 14165
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License Number State | CT
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