Basic Information
Provider Information
NPI: 1275067332
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CRAIK
FirstName: NATALIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3200 E CAMELBACK RD STE 250
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850182327
CountryCode: US
TelephoneNumber: 6029331814
FaxNumber: 6029338972
Practice Location
Address1: 1919 E THOMAS RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850167710
CountryCode: US
TelephoneNumber: 6029332923
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/16/2017
LastUpdateDate: 12/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X61016AZN Allopathic & Osteopathic PhysiciansPediatrics 
208M00000X61016AZY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


Home