Provider Demographics
NPI:1700229820
Name:CRAFT, SHELLEY BURAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:BURAN
Last Name:CRAFT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 W CARY ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-2728
Mailing Address - Country:US
Mailing Address - Phone:804-254-6400
Mailing Address - Fax:
Practice Address - Street 1:3507 W CARY ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-2728
Practice Address - Country:US
Practice Address - Phone:804-254-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202006362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist