Individual
SOPHIA GRACE CREEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STUDENT
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-6863
Mailing address
1227 W SAGE CT, SPRINGFIELD, MO 65810-6015
(515) 520-1311
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN2339261
MA
390200000X
Student in an Organized Health Care Education/Training Program
134793
IA
Other
Enumeration date
04/14/2018
Last updated
09/06/2024
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