Craddock, Alicia M
Craddock, Alicia M is an individual health care provider with primary practice located at 2540 Windy Hill Rd Se , Marietta GA 30067-8605. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Craddock, Alicia M can be contacted via phone (770) 644-1274.Contact Information
Primary practice address
2540 Windy Hill Rd Se
Marietta GA 30067-8605
Phone: (770) 644-1274
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | RN0000154198 | Tennessee |
| Nursing Service Providers / Registered Nurse | 163W00000X | RN168147 | Georgia |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | APN0000013603 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | RN168147 | Georgia |
Profile Details
| NPI number | 1124283999 |
|---|---|
| LBN Legal business name | Craddock, Alicia M |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 22nd, 2008 |
| Last updated | May 22nd, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124283999 | NPPES |
| Tennessee | Other | P00770314 | RAILROAD MEDICARE |
| Tennessee | Other | N480408 | RAILROAD MEDICARE |
| Tennessee | MEDICAID | 8053486 | RAILROAD MEDICARE |
| Tennessee | MEDICAID | 108083 | RAILROAD MEDICARE |
| Tennessee | MEDICAID | 662969153A | RAILROAD MEDICARE |
| Tennessee | Other | 4157214 | RAILROAD MEDICARE |
| Tennessee | MEDICAID | 1510651 | RAILROAD MEDICARE |
Popular Providers
-
Gloss, Theresa H.
2550 Windy Hill Rd Se Suite 302, Marietta GA 30067-8665 -
Rutledge, Sherri M.
780 Canton Road Suite 100, Marietta GA 30060-7259 -
Lottman, Jerome Andrew
4106 Columns Dr Se , Marietta GA 30067-9105 -
Limonta, Melissa D.
2540 Windy Hill Rd Se , Marietta GA 30067-8605 -
Jeter, Leslie A.
2550 Windy Hill Rd Se Suite 302, Marietta GA 30067-8665 -
Sumpter, Sheila F.
780 Canton Road Suite 100, Marietta GA 30060-7259 -
Thompson, Elizabeth A.
2550 Windy Hill Rd Se Suite 302, Marietta GA 30067-8665 -
Smith, Rhonda Lynn
677 Church St Ne , Marietta GA 30060-1101