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General NPI Number Information
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NPI Number | 1558394692
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Entity Type | Individual
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Provider Name | JOELLE M CREAGER FNP
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Gender | Female
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 698 12TH ST
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City | OGDEN
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State | UT
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Zip | 84404-5877
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Country | US
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Telephone | 801-621-3466
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Fax |
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Provider Business Mailing Address
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Address Line | 1055 N 500 W
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City | PROVO
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State | UT
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Zip | 84604-3305
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Country | US
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Telephone | 801-375-8858
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Fax | 801-418-0941
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2654394405
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License Number State | UT
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