Individual
JEFF CRAIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
HWY 160 MP 394.3, KAYENTA, AZ 86033
(928) 697-4100
(928) 697-4029
Mailing address
PO BOX 368, KAYENTA, AZ 86033-0368
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
102592
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030073
MEDICARE
AZ
05
—
060012
—
AZ
Enumeration date
11/08/2019
Last updated
11/08/2019
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