Provider Demographics
NPI:1508252628
Name:CREASMAN, LAURA (LPN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CREASMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 S HOPE WELL RD
Mailing Address - Street 2:
Mailing Address - City:KENEFIC
Mailing Address - State:OK
Mailing Address - Zip Code:74748-8108
Mailing Address - Country:US
Mailing Address - Phone:903-559-1167
Mailing Address - Fax:
Practice Address - Street 1:806 BRYAN DRIVE
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701
Practice Address - Country:US
Practice Address - Phone:580-920-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management