Provider Demographics
NPI:1649720806
Name:CREATH, MEGHAN (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:CREATH
Suffix:
Gender:
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP, APRN, FNP-C
Mailing Address - Street 1:2317 FIRESTONE CIR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5871
Mailing Address - Country:US
Mailing Address - Phone:903-521-6067
Mailing Address - Fax:
Practice Address - Street 1:410 N COLLEGIATE DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-4886
Practice Address - Country:US
Practice Address - Phone:903-204-4007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132147363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily