Individual
KIMBERLY JANE CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-0368
Mailing address
71464 HAYNES AVE, ABITA SPRINGS, LA 70420-3422
(985) 373-6970
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
310417
LA
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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