Provider Demographics
NPI:1487157707
Name:CRAIGHEAD, ANDREA ESTHER (APN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:ESTHER
Last Name:CRAIGHEAD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 24 1/2 RD STE F
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1277
Mailing Address - Country:US
Mailing Address - Phone:970-644-5013
Mailing Address - Fax:970-658-1138
Practice Address - Street 1:627 24 1/2 RD STE F
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1277
Practice Address - Country:US
Practice Address - Phone:970-644-5013
Practice Address - Fax:970-658-1138
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11095363LP0808X
COC-APN.0001390-C-NP363LP0808X
COAPN.0995456-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health