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Individual

MELANIE J CRADDOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CDCES

Contact information

Practice address
95 MAHALANI STREET RM 28-4, WAILUKU, HI 96793-9217
(808) 867-0623
Mailing address
PO BOX 1639, KIHEI, HI 96753-1639
(808) 868-8968

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
75952
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26831
RN LICENSE
MT
01
32305624
CERTIFICATION BOARD FOR DIABETES CARE AND EDUCATION
01
75952
RN LICENSE
HI
Enumeration date
06/20/2012
Last updated
02/05/2025
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