Provider Demographics
NPI:1043915283
Name:CRAIG, LILA LEIGH (APRN)
Entity Type:Individual
Prefix:
First Name:LILA
Middle Name:LEIGH
Last Name:CRAIG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-430-2225
Mailing Address - Fax:606-886-8176
Practice Address - Street 1:723 S LAKE DR
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-1340
Practice Address - Country:US
Practice Address - Phone:606-886-8175
Practice Address - Fax:606-886-8176
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1144337163WM0705X
KY4000733363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical