Creedon, Katie A
Creedon, Katie A is an individual health care provider with primary practice located at 940 Belmont St , Brockton MA 02301-5596. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Creedon, Katie A can be contacted via phone (774) 826-1866.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 252810 | Massachusetts |
Profile Details
| NPI number | 1538350673 |
|---|---|
| LBN Legal business name | Creedon, Katie A |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 5th, 2007 |
| Last updated | Jun 13th, 2023 - about 2 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 | 1538350673 | NPPES |
| Massachusetts | MEDICAID | 110077919A |
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