Provider Demographics
NPI:1194157867
Name:CREECH, KARA KAE (RN)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:KAE
Last Name:CREECH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:KAE
Other - Last Name:OLDFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1116 PLAZA AZUL
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-4432
Mailing Address - Country:US
Mailing Address - Phone:520-266-5084
Mailing Address - Fax:
Practice Address - Street 1:1116 PLAZA AZUL
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-4432
Practice Address - Country:US
Practice Address - Phone:520-266-5084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN098769163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse