Creaser, Kellie Marie

Creaser, Kellie Marie is an individual health care provider with primary practice located at 840 Hassett St , Brookings OR 97415-7201. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Creaser, Kellie Marie can be contacted via phone (307) 351-3666.

Contact Information

Primary practice address
840 Hassett St Brookings OR 97415-7201
Phone: (307) 351-3666
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 201908534NP-PP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 201908534NP-PP Oregon

Profile Details

NPI number 1740821453
LBN Legal business name Creaser, Kellie Marie
Credentials FNP, PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2019
Last updated Dec 4th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740821453 NPPES
Oregon MEDICAID 500771078
Oregon Other 1083656367

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