Active NPI
Andrea Marie Craft, LPN
- Licensed Practical Nurse
- Hermanville, MS
National Provider Identifier
1538377692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- P316647
- Practice address
- 6116 Shelby Rd
Hermanville, MS 39086-9620 - Phone
- (601) 535-7937
- Fax
- (601) 535-7937
- NPI assigned
- May 20, 2007
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | P316647 | MS | Primary |
Addresses
Primary practice location
6116 Shelby Rd
Hermanville, MS 39086-9620
Mailing address
6116 Shelby Rd
Hermanville, MS 39086-9620
Phone (601) 535-7937
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00770524 | Medicaid | MS | |
| P316647 | Other | MS | NURSING LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P316647 | MS | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1538377692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6116 SHELBY RD",
"city": "HERMANVILLE",
"state": "MS",
"postal_code": "390869620",
"telephone_number": "601-535-7937",
"fax_number": "601-535-7937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6116 SHELBY RD",
"city": "HERMANVILLE",
"state": "MS",
"postal_code": "390869620",
"telephone_number": "601-535-7937",
"fax_number": "601-535-7937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAFT",
"first_name": "ANDREA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MS",
"license": "P316647",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00770524",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSING LICENSE NUMBER",
"identifier": "P316647",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hermanville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.