Provider Demographics
NPI:1891866174
Name:CREEKMORE, JANET ELLEN (RN FNP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ELLEN
Last Name:CREEKMORE
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 254
Mailing Address - Street 2:201 S FIRST ST
Mailing Address - City:PIERCETON
Mailing Address - State:IN
Mailing Address - Zip Code:46562
Mailing Address - Country:US
Mailing Address - Phone:574-594-5386
Mailing Address - Fax:
Practice Address - Street 1:505 S 3RD ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516
Practice Address - Country:US
Practice Address - Phone:574-294-7561
Practice Address - Fax:574-293-5479
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28083616A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health