Basic Information
Provider Information
NPI: 1194199547
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CREAGER
FirstName: ASHLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1453 HOPE WAY
Address2:  
City: MURFREESBORO
State: TN
PostalCode: 371293140
CountryCode: US
TelephoneNumber: 6158939390
FaxNumber: 6158934162
Practice Location
Address1: 1453 HOPE WAY
Address2:  
City: MURFREESBORO
State: TN
PostalCode: 371293140
CountryCode: US
TelephoneNumber: 6158939390
FaxNumber: 6158934162
Other Information
ProviderEnumerationDate: 11/23/2015
LastUpdateDate: 08/16/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/16/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X20452TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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