Provider Demographics
NPI:1659578243
Name:CREIGHTON, NATASHA KELLY (MD)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:KELLY
Last Name:CREIGHTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:39000 BOB HOPE DR
Mailing Address - Street 2:UIHLEIN BLDG 2ND FLR
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-834-7970
Mailing Address - Fax:760-834-7971
Practice Address - Street 1:39000 BOB HOPE DR
Practice Address - Street 2:UIHLEIN BLDG 2ND FLR.
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-834-7970
Practice Address - Fax:760-834-7971
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA111863207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine