Individual
ASHLEY MARISSA CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3102 GOODMAN RD W, HORN LAKE, MS 38637-1172
(662) 342-6676
Mailing address
3102 GOODMAN RD W, HORN LAKE, MS 38637-1172
(662) 342-6676
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R882607
MS
Other
Enumeration date
01/19/2015
Last updated
01/19/2015
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