MEDICARE: COURTNEY CREATER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant	016694	IN

General Provider Information

NPI Number	:	1124973532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY CREATER

Provider Business Mailing Address
First Line	:	4410 THORNLEIGH DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46226-2166
Country	:	US
Telephone Number	:	833-987-5337
Fax Number	:	317-932-5467

Provider Business Practice Location Address
First Line	:	4410 THORNLEIGH DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46226-2166
Country	:	US
Telephone Number	:	833-987-5337
Fax Number	:	317-932-5467

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ COURTNEY CREATER ” Practice Location

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