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NPI Code Detail

MEDICARE: CRAIG STEVEN JOSEPH LPN

MEDICARE:   CRAIG STEVEN JOSEPH  LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NursePN.143192-M-IVOH

General Provider Information

NPI Number : 1184969107
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG STEVEN JOSEPH LPN
Provider Business Mailing Address
First Line : 6163 BELLVERNON DR
Second Line :
City : OSSEO
State : MI
Zip : 49266-9713
Country : US
Telephone Number : 517-797-5482
Fax Number : 517-797-5482
Provider Business Practice Location Address
First Line : 6163 BELLVERNON DR
Second Line :
City : OSSEO
State : MI
Zip : 49266-9713
Country : US
Telephone Number : 517-797-4637
Fax Number : 517-797-5482
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2012
Last Update Date : 12/03/2012

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Directions to “ CRAIG STEVEN JOSEPH LPN” Practice Location

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