Provider Demographics
NPI:1497458665
Name:CREECH, ERICA (APRN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:CREECH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2123 AUBURN AVE STE 404
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-241-5630
Mailing Address - Fax:513-241-7146
Practice Address - Street 1:830 THOMAS MORE PKWY STE 202
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-5103
Practice Address - Country:US
Practice Address - Phone:859-341-6281
Practice Address - Fax:859-341-4661
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1161341163W00000X
KY4006496363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse