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Individual

MS. JANET CRADIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
F.N.P.

Contact information

Practice address
111 W STONE DR STE 110, KINGSPORT, TN 37660-6027
(423) 224-3701
(423) 224-3709
Mailing address
1101 E STONE DR, SUITE 2, KINGSPORT, TN 37660-3384
(423) 224-1110
(423) 224-1130

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024166194
VA
363LF0000X
Family Nurse Practitioner
Primary
5587
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1497758551
VA
05
3904543
TN
01
P00910852
RR MEDICARE
TN
Enumeration date
05/23/2005
Last updated
06/05/2018
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