Provider Demographics
NPI:1184974552
Name:CRAIG, ANDREA OLIVIA (RN, CNP - PSYCHIATRY)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:OLIVIA
Last Name:CRAIG
Suffix:
Gender:F
Credentials:RN, CNP - PSYCHIATRY
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Mailing Address - Street 1:415 JEFFERSON ST N
Mailing Address - Street 2:
Mailing Address - City:WADENA
Mailing Address - State:MN
Mailing Address - Zip Code:56482-1264
Mailing Address - Country:US
Mailing Address - Phone:218-631-3510
Mailing Address - Fax:218-631-7503
Practice Address - Street 1:800 BEMIDJI AVE N STE 200
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3056
Practice Address - Country:US
Practice Address - Phone:218-631-3510
Practice Address - Fax:218-631-7503
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR-138001-7363LP0808X
MNR-138-001-7363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health