Kimberly Harriet Creater
Specialist in Fultonville, NY. Individual provider (NPI-1).
NPI number1639802416
StatusActive
Last updated in NPPESJul 8, 2022
Details
- NPI
- 1639802416
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kimberly Harriet Creater
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 8, 2022
- Certification date
- Jul 8, 2022
- Last updated
- Jul 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
145 Sara Lib RdFultonville, NY 12072-3245
Phone 315-360-5819
Mailing address
145 Sara Lib RdFultonville, NY 12072-3245
Phone 315-360-5819
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