MEDICARE: SHELLI RENEE CRAIG

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	363L00000X	Nurse Practitioner	AP145773	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP145773	TX

General Provider Information

NPI Number	:	1720617699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELLI RENEE CRAIG

Provider Business Mailing Address
First Line	:	2525 KELL BLVD STE 302
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-1049
Country	:	US
Telephone Number	:	940-432-3444
Fax Number	:	940-432-5558

Provider Business Practice Location Address
First Line	:	2525 KELL BLVD STE 302
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-1049
Country	:	US
Telephone Number	:	940-432-3444
Fax Number	:	940-432-5558

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

Provider Enumeration Date	:	04/03/2020
Last Update Date	:	12/11/2025

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Directions to “ SHELLI RENEE CRAIG ” Practice Location

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