Provider Demographics
NPI:1790963098
Name:CRAIG, LILLIAN H (RN,FNP-C)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:H
Last Name:CRAIG
Suffix:
Gender:F
Credentials:RN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BAYSHORE DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79118-4421
Mailing Address - Country:US
Mailing Address - Phone:806-622-9683
Mailing Address - Fax:
Practice Address - Street 1:3300 I-40 E
Practice Address - Street 2:SUITE 400
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79103-4801
Practice Address - Country:US
Practice Address - Phone:806-331-8308
Practice Address - Fax:806-379-7661
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX249699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily