Provider Demographics
NPI:1467935114
Name:CRAIG, ANGELA JO (APRN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:JO
Last Name:CRAIG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:JO
Other - Last Name:MOUNCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2000 S 42ND ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-2001
Mailing Address - Country:US
Mailing Address - Phone:479-273-9173
Mailing Address - Fax:
Practice Address - Street 1:2000 S 42ND ST STE 100
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-2001
Practice Address - Country:US
Practice Address - Phone:479-273-9173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily