Individual
AMY CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
101 ADAMS ST, JEFFERSON CITY, MO 65101-3058
(573) 556-6589
(573) 556-6294
Mailing address
900 E LAHARPE ST, KIRKSVILLE, MO 63501-4520
(660) 665-1962
(660) 665-3989
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
094783
MO
Other
Enumeration date
06/01/2010
Last updated
06/01/2010
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