Provider Demographics
NPI:1760201693
Name:MONICA L CRAIG NP-C LLC
Entity type:Organization
Organization Name:MONICA L CRAIG NP-C LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-247-0572
Mailing Address - Street 1:137 SE CRAIG AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-4968
Mailing Address - Country:US
Mailing Address - Phone:386-247-0572
Mailing Address - Fax:286-287-6525
Practice Address - Street 1:137 SE CRAIG AVE
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-4968
Practice Address - Country:US
Practice Address - Phone:386-247-0572
Practice Address - Fax:286-287-6525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty