Kevin J. Creedon, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP009318 Issued in PA

Practice address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236

Phone

(210) 395-9127

NPI assigned

Jan 10, 2007

Last updated

Jun 29, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1851440531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 LEEBERNARD CHAVIS CT",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782361052",
            "telephone_number": "210-395-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-395-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEDON",
        "first_name": "KEVIN",
        "middle_name": "J.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R230746",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "RN502279L",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP009318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Cotton, LCSW
• Veronica Couture, M.D.
• Denise Renee Covert, FNP-C
• Kiersten Craig, MD
• Charles Nicolas Crain
• Daniel M Cromwell, M.S.
• Daniel Roberto Cruz, DPM
• Peter John Cuenca, M.D.
• Lindsey Allison Cunningham, DMD
• Kelly Lynn Czeiszperger, CSW

• Psychiatric/Mental Health Nurse Practitioner in Jbsa Lackland, TX
• Providers in Jbsa Lackland, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.