Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APN.23047 | SC |
Y | 363L00000X | Nurse Practitioner | R009034 | OK |
NPI | 1003468745 |
---|---|
Provider Name | Lori M Craig |
First Address | Oklahoma City, OK 73114-2000 |
Second Address | Oklahoma City, OK 73114-2000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2019 |
Last Update Date | 04/06/2021 |