Provider Demographics
NPI:1790978211
Name:CREECH, JUDY (RN/FNP)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:CREECH
Suffix:
Gender:F
Credentials:RN/FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 S CLACK ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-1557
Mailing Address - Country:US
Mailing Address - Phone:325-690-5131
Mailing Address - Fax:325-690-5228
Practice Address - Street 1:2626 S CLACK ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-1557
Practice Address - Country:US
Practice Address - Phone:325-690-5100
Practice Address - Fax:325-690-5228
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP112205363LP0808X
TX562224363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily