| Doctor Name: | NOLAN CRAIN |
| NPI Number: | 1063840577 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | |
| Business Practice Address: | Hp217 F Street Camp Lejeune, NC - 285420042 |
| Business Phone Number: | 9104513607 |
| Business Fax Number: | |
| Mailing Address: | 5055 Western Blvd Apt 1b, JACKSONVILLE |
| State: | NC |
| Postal Code: | 285466884 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/18/2013 |
| NPI Last Update Date: | 10/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |