Basic Information
| Provider Information | |||||||||
| NPI: | 1487026423 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | CREED | ||||||||
| FirstName: | PETER | ||||||||
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| Credential: | APNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1308 E KENSINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532111529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4146781545 | ||||||||
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| Practice Location | |||||||||
| Address1: | 611 12TH AVE S | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981442007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063249360 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2015 | ||||||||
| LastUpdateDate: | 10/16/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP6106944 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 6488 | WI | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.