Provider Demographics
NPI:1790444768
Name:CREED, RENATA MARIA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:RENATA
Middle Name:MARIA
Last Name:CREED
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 DAWN BROOK LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3739
Mailing Address - Country:US
Mailing Address - Phone:713-979-8969
Mailing Address - Fax:
Practice Address - Street 1:17947 INTERSTATE 45 S STE 226
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8785
Practice Address - Country:US
Practice Address - Phone:713-979-8969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-16
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06211525363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily