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General NPI Number Information
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NPI Number | 1659295780
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Entity Type | Individual
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Provider Name | MIA CREEKMORE MSN, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/10/2026
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Last Update Date | 08/10/2026
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Provider Practice Location Address
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Address Line | 2277 NC 24 UNIT 87
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City | CAMERON
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State | NC
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Zip | 28326-7671
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Country | US
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Telephone | 919-373-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 148 MONTEBURG RD
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City | FORT BRAGG
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State | NC
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Zip | 28307-1720
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Country | US
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Telephone | 727-638-5582
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5025173
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License Number State | NC
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