Provider Demographics
NPI:1881249746
Name:CRADDOCK, SARAH GAIL
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:GAIL
Last Name:CRADDOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6562 E CALLE DENED
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-5614
Mailing Address - Country:US
Mailing Address - Phone:520-954-1814
Mailing Address - Fax:
Practice Address - Street 1:6562 E CALLE DENED
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-5614
Practice Address - Country:US
Practice Address - Phone:520-954-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider