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Individual

ASHLEY CRAIG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
920 CLAYBURN DR, FORT WAYNE, IN 46819-1431
(269) 258-6237
Mailing address
920 CLAYBURN DR, FORT WAYNE, IN 46819-1431
(269) 258-6237

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27071178A
IN
174400000X
Specialist
BC20705501
IN

Other

Enumeration date
03/15/2023
Last updated
03/27/2023
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