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General NPI Number Information
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NPI Number | 1760201693
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Entity Type | Organization
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Legal Business Name | MONICA L CRAIG NP-C LLC
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 137 SE CRAIG AVE
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City | LAKE CITY
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State | FL
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Zip | 32025-4968
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Country | US
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Telephone | 386-247-0572
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Fax | 286-287-6525
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Provider Business Mailing Address
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Address Line | 137 SE CRAIG AVE
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City | LAKE CITY
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State | FL
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Zip | 32025-4968
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Country | US
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Telephone | 386-247-0572
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Fax | 286-287-6525
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Authorized Official
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Title or Position | OWNER
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Name | MONICA CRAIG
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Credential |
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Telephone | 386-247-0572
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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 |
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License Number State |
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