Provider Demographics
NPI:1053551028
Name:CRAIG, MARTINA S (LPN)
Entity type:Individual
Prefix:MRS
First Name:MARTINA
Middle Name:S
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:MARTINA
Other - Middle Name:S
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:2026 WINDMILL WAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3344
Mailing Address - Country:US
Mailing Address - Phone:513-371-8456
Mailing Address - Fax:
Practice Address - Street 1:2026 WINDMILL WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3344
Practice Address - Country:US
Practice Address - Phone:513-371-8456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN099624164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse