| NPI | 1689767790 |
|---|---|
| Former Name | KATHLEEN ANN CREEDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: NY F331634) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F331634) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-10-16 |