Provider Demographics
NPI:1568918464
Name:CRAIG, LAURA A (RN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
Last Name:CRAIG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31619 N 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-7068
Mailing Address - Country:US
Mailing Address - Phone:816-914-4594
Mailing Address - Fax:
Practice Address - Street 1:35707 N 33RD LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-2289
Practice Address - Country:US
Practice Address - Phone:623-445-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN184009163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse