Provider Demographics
NPI:1235610304
Name:CREASON, AMY (FNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CREASON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10635 DELTA DR
Mailing Address - Street 2:
Mailing Address - City:BROWNING
Mailing Address - State:MO
Mailing Address - Zip Code:64630-9775
Mailing Address - Country:US
Mailing Address - Phone:660-946-4594
Mailing Address - Fax:660-258-4002
Practice Address - Street 1:130 E LOCKLING ST
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:MO
Practice Address - Zip Code:64628-2337
Practice Address - Country:US
Practice Address - Phone:660-258-1050
Practice Address - Fax:660-258-1052
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2018021097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2018021097OtherMISSOURI STATE BOARD OF NURSING