Provider Demographics
NPI:1669676425
Name:CRAIG, AMIE A (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:AMIE
Middle Name:A
Last Name:CRAIG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-5715
Mailing Address - Country:US
Mailing Address - Phone:478-477-8869
Mailing Address - Fax:
Practice Address - Street 1:4000 VINEVILLE AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-5038
Practice Address - Country:US
Practice Address - Phone:478-477-9412
Practice Address - Fax:478-477-9415
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN137039 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily