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NPI Code Detail

MEDICARE: MR. JOSEPH MICHAEL CREAGER RN

MEDICARE: MR. JOSEPH MICHAEL CREAGER RN
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
1163W00000XRegistered NurseR028299SD

General Provider Information

NPI Number : 1225165756
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH MICHAEL CREAGER RN
Provider Business Mailing Address
First Line : 1210 W 17TH ST
Second Line :
City : YANKTON
State : SD
Zip : 57078-1922
Country : US
Telephone Number : 605-664-2543
Fax Number :
Provider Business Practice Location Address
First Line : 110 S VISITING EAGLE ST
Second Line :
City : NIOBRARA
State : NE
Zip : 68760-7201
Country : US
Telephone Number : 402-857-2300
Fax Number : 402-857-2594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 07/08/2007

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