Individual
KEVIN J. CREEDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236
(210) 395-9127
Mailing address
2624 LEEBERNARD CHAVIS CT, JBSA LACKLAND, TX 78236-1052
(210) 395-9127
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R230746
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN502279L
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP009318
PA
Other
Enumeration date
01/10/2007
Last updated
06/29/2018
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