Provider Demographics
NPI:1003627209
Name:CRAIG, SHELBY (NP)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 GREENE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2385
Mailing Address - Country:US
Mailing Address - Phone:706-722-6900
Mailing Address - Fax:706-722-5118
Practice Address - Street 1:701 GREENE ST STE 200
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2385
Practice Address - Country:US
Practice Address - Phone:706-722-6900
Practice Address - Fax:706-722-5118
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP003865363LA2100X, 363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology