Provider Demographics
NPI:1013171602
Name:CRAGER, EDITH D (RN)
Entity Type:Individual
Prefix:MS
First Name:EDITH
Middle Name:D
Last Name:CRAGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:EDITH
Other - Middle Name:D
Other - Last Name:CRAGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:7338 MILLERS RUN FALLEN TIMBER RD
Mailing Address - Street 2:
Mailing Address - City:LUCASVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45648-8352
Mailing Address - Country:US
Mailing Address - Phone:740-841-4290
Mailing Address - Fax:
Practice Address - Street 1:7338 MILLERS RUN FALLEN TIMBER RD
Practice Address - Street 2:
Practice Address - City:LUCASVILLE
Practice Address - State:OH
Practice Address - Zip Code:45648-8352
Practice Address - Country:US
Practice Address - Phone:740-841-4290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN252922163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse