MEDICARE: MRS. ANDREA ROTH CRAIG DNP, FNP-BC

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
1	163W00000X	Registered Nurse	RN203861	AZ
2	363LF0000X	Family Nurse Practitioner	335472	AZ

General Provider Information

NPI Number	:	1306565262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANDREA ROTH CRAIG DNP, FNP-BC

Provider Business Mailing Address
First Line	:	2325 W CAPRICORN ST
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85742-8435
Country	:	US
Telephone Number	:	847-682-5799
Fax Number	:

Provider Business Practice Location Address
First Line	:	5555 E 5TH ST STE 101
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-2415
Country	:	US
Telephone Number	:	520-886-4181
Fax Number	:	520-721-7536

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2022
Last Update Date	:	02/11/2026

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