Provider Demographics
NPI:1730106691
Name:CRAFT, SIRI PERRY (FNP GNP)
Entity Type:Individual
Prefix:
First Name:SIRI
Middle Name:PERRY
Last Name:CRAFT
Suffix:
Gender:F
Credentials:FNP GNP
Other - Prefix:
Other - First Name:SIRI
Other - Middle Name:ROBIN
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1330 BOILING SPRINGS ROAD
Mailing Address - Street 2:SUITE 2700
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303
Mailing Address - Country:US
Mailing Address - Phone:864-583-0053
Mailing Address - Fax:864-583-0390
Practice Address - Street 1:1330 BOILING SPRINGS ROAD
Practice Address - Street 2:SUITE 2700
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303
Practice Address - Country:US
Practice Address - Phone:864-583-0053
Practice Address - Fax:864-583-0390
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN2656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ70590Medicare UPIN
SCQ705905640Medicare PIN
SCQ705906655Medicare PIN