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NPI Code Detail

MEDICARE: MRS. BARBARA A CREE PAC

MEDICARE: MRS. BARBARA A CREE PAC
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
1363A00000XPhysician Assistant085002621IL
2363A00000XPhysician Assistant000974IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467423111
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BARBARA A CREE PAC
Provider Business Mailing Address
First Line : 3933 MOUNT VERNON RD SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52403-3869
Country : US
Telephone Number : 319-363-8148
Fax Number : 319-363-9118
Provider Business Practice Location Address
First Line : 3933 MOUNT VERNON RD SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52403-3869
Country : US
Telephone Number : 319-363-8148
Fax Number : 319-363-9118
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 02/21/2017

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Directions to “ MRS. BARBARA A CREE PAC” Practice Location

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