Individual
JESSIE CREAKBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1168 FIRST COLONIAL RD STE 201, VIRGINIA BEACH, VA 23454
(757) 481-1113
(757) 496-3822
Mailing address
PO BOX 7068, PORTSMOUTH, VA 23707-0068
(757) 686-3508
(757) 686-0541
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-005125
VA
363A00000X
Physician Assistant
0110005125
VA
Other
Enumeration date
10/26/2015
Last updated
07/09/2018
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