Individual
MRS. ALISA CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHC-NP
Contact information
Practice address
1501 S TAYLOR ST, AMARILLO, TX 79101-4307
(806) 372-8731
(806) 372-8746
Mailing address
1501 S TAYLOR ST, AMARILLO, TX 79101-4307
(806) 372-8731
(806) 372-8746
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
516437
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153890-20
—
TX
Enumeration date
05/24/2006
Last updated
07/08/2007
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