Provider Demographics
NPI:1396803391
Name:CREITZ, CARLA ELAINE (RN)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:ELAINE
Last Name:CREITZ
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:1061 HARMON AVENUE
Mailing Address - Street 2:ROOM 2C22
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314
Mailing Address - Country:US
Mailing Address - Phone:912-435-6954
Mailing Address - Fax:912-435-5966
Practice Address - Street 1:1061 HARMON AVE
Practice Address - Street 2:ROOM 2C22
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5641
Practice Address - Country:US
Practice Address - Phone:912-435-6954
Practice Address - Fax:912-435-5966
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2015-10-29
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Provider Licenses
StateLicense IDTaxonomies
GARN147207163W00000X
TX652861163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator