Mary Craddock

Licensed Practical Nurse · Tyler, TX

Individual Active NPI

NPI number 1194436790

Practice location

9846 Hwy 31 E
Tyler, TX 75705-2329
Phone
(903) 525-3995
Fax
(903) 525-3858

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NPI record

NPI
1194436790
Entity type
Individual (Type 1)
Enumeration date
December 6, 2022
Last updated
December 6, 2022
Certified
December 6, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Licensed Practical Nurse Primary 164W00000X 165013 TX

About Mary Craddock

Mary Craddock is a healthcare provider registered in the NPI registry with the primary taxonomy Licensed Practical Nurse (code 164W00000X). The practice location is 9846 Hwy 31 E, Tyler, TX 75705-2329. The NPI number 1194436790 was assigned on December 6, 2022 and the record was last updated on December 6, 2022.

Mary Craddock lists a license in the registry: #165013 (TX) for Licensed Practical Nurse. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mary Craddock?

The NPI number is 1194436790.

What is the phone number of Mary Craddock?

The phone number listed for the practice location is (903) 525-3995.

Where is Mary Craddock located?

9846 Hwy 31 E, Tyler, TX 75705-2329.

What is the taxonomy code for Mary Craddock?

The primary taxonomy code is 164W00000X – Licensed Practical Nurse.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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