Creely, Mary Jane T

Creely, Mary Jane T is an sole proprietor health care provider with primary practice located at 127 Johnny Cake Hill Rd , Middletown RI 02842-5674. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult, which is considered as her primary health care specialty. Creely, Mary Jane T can be contacted via phone (401) 846-1213.

Contact Information

Primary practice address
127 Johnny Cake Hill Rd Middletown RI 02842-5674
Phone: (401) 846-1213
Fax: (401) 848-9151
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult 364SP0809X PNS00002 Rhode Island

Profile Details

NPI number 1356484265
LBN Legal business name Creely, Mary Jane T
Credentials MS, RN, PCNS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 14th, 2007
Last updated Jul 8th, 2007 - about 18 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 1356484265 NPPES
Rhode Island MEDICAID MC14017

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