Individual
MRS. JENNIFER CARTER CREDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3100 NC HWY 55, SUITE 102, CARY, NC 27519-8427
(919) 363-5000
(919) 363-5346
Mailing address
2920 RIDGEPINE DR, APEX, NC 27502-7934
(919) 363-5000
(919) 363-5346
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2215
NC
225100000X
Physical Therapist
Primary
P2215
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0786I
BCBS PROVIDER NUMBER
NC
Enumeration date
01/09/2007
Last updated
02/09/2017
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