Individual
KATIE A CREEDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(774) 826-1866
Mailing address
100 FOREST DR, BRIDGEWATER, MA 02324-2330
(603) 387-7684
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
252810
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110077919A
—
MA
Enumeration date
08/05/2007
Last updated
06/13/2023
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