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Individual
KELLY-ANN P CRADDOCK
Active
Individual
KELLY-ANN P CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
286516-1
NY
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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