Provider Demographics
NPI:1073033262
Name:CREEDEN, CHRISTINA M (NP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:CREEDEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:WAMMACK, DOWDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 992790
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96099-2790
Mailing Address - Country:US
Mailing Address - Phone:530-246-5710
Mailing Address - Fax:870-994-7488
Practice Address - Street 1:2965 EAST ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:CA
Practice Address - Zip Code:96007-3481
Practice Address - Country:US
Practice Address - Phone:303-780-4865
Practice Address - Fax:530-357-0582
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005178363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARA005178OtherAPRN LICENSE