Healthcare Provider Details

I. General information

NPI: 1558270066
Provider Name (Legal Business Name): CASEY LYNN CREED RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

5714 DAVID PL
FAIRFIELD OH
45014-3506
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-1526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License NumberLD.10189
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: