Provider Demographics
NPI:1487026423
Name:CREED, PETER (APNP)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:CREED
Suffix:
Gender:M
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 E KENSINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-1529
Mailing Address - Country:US
Mailing Address - Phone:414-678-1545
Mailing Address - Fax:
Practice Address - Street 1:4220 S 27TH ST STE 200
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53221-1855
Practice Address - Country:US
Practice Address - Phone:414-282-5180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP6106944363LF0000X
WI6488363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily