Provider Demographics
NPI:1396305264
Name:CREAGER, MALAURA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MALAURA
Middle Name:
Last Name:CREAGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MALAURA
Other - Middle Name:
Other - Last Name:GUY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:510 E HOPI ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-6821
Mailing Address - Country:US
Mailing Address - Phone:435-764-1368
Mailing Address - Fax:
Practice Address - Street 1:NORTH HWY 491
Practice Address - Street 2:
Practice Address - City:SHIPROCK
Practice Address - State:NM
Practice Address - Zip Code:87420
Practice Address - Country:US
Practice Address - Phone:505-368-7256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist