Provider Demographics
NPI:1649562950
Name:CREASY, KERRY RAE (PHD, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:RAE
Last Name:CREASY
Suffix:
Gender:F
Credentials:PHD, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 SW ARCHER ROAD
Mailing Address - Street 2:MALCOLM RANDALL VAMC MHC 116A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608
Mailing Address - Country:US
Mailing Address - Phone:352-384-3560
Mailing Address - Fax:353-847-7293
Practice Address - Street 1:1601 SW ARCHER ROAD
Practice Address - Street 2:MALCOLM RANDALL VAMC MHC 116A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608
Practice Address - Country:US
Practice Address - Phone:352-548-6456
Practice Address - Fax:352-271-4574
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9281775163W00000X
FLARNP9281775163WP0809X
FLAPRN9281775163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163W00000XNursing Service ProvidersRegistered Nurse