Individual
CHARLIE CRAFTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
701 S HOLLY AVE, COLLINS, MS 39428-3894
(601) 765-6711
Mailing address
701 S HOLLY AVE, COLLINS, MS 39428-3894
(601) 765-6711
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
905959
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
897824
MISSISSIPPI BOARD OF NURSING
MS
01
—
905959
MISSISSIPPI BOARD OF NURSING
MS
Enumeration date
09/20/2022
Last updated
04/25/2023
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