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Individual

MICAH U CRAIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1115 E TYLER ST, ATHENS, TX 75751-2145
(903) 292-5015
Mailing address
PO BOX 14950, OKLAHOMA CITY, OK 73113-0950
(405) 445-1210

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
850038
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1204401
TX

Other

Enumeration date
05/27/2025
Last updated
06/16/2025
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