Provider Demographics
NPI:1922697598
Name:MCCREADY, BOBBIE JO (FNP)
Entity Type:Individual
Prefix:
First Name:BOBBIE
Middle Name:JO
Last Name:MCCREADY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 MIDDLETOWN ODESSA RD FL 2
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9602
Mailing Address - Country:US
Mailing Address - Phone:302-203-2230
Mailing Address - Fax:302-203-2240
Practice Address - Street 1:621 MIDDLETOWN ODESSA RD FL 2
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-9602
Practice Address - Country:US
Practice Address - Phone:302-203-2230
Practice Address - Fax:302-203-2240
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR157031163W00000X
DELG-0001431363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse