Provider Demographics
NPI:1043740426
Name:CRAIG, ANNICE JEAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANNICE
Middle Name:JEAN
Last Name:CRAIG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 BONE ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:AR
Mailing Address - Zip Code:72031-6609
Mailing Address - Country:US
Mailing Address - Phone:501-745-4266
Mailing Address - Fax:501-745-4266
Practice Address - Street 1:129 BONE ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:AR
Practice Address - Zip Code:72031-6609
Practice Address - Country:US
Practice Address - Phone:501-745-4266
Practice Address - Fax:501-745-5707
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD14049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist