Individual
MRS. LATARA K CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2668 PETERS CREEK PKWY, WINSTON SALEM, NC 27127-5655
(336) 200-7020
Mailing address
PO BOX 746724, ATLANTA, GA 30374-6724
(312) 644-3941
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5013213
NC
Other
Enumeration date
04/28/2020
Last updated
04/26/2024
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