Provider Demographics
NPI:1548998099
Name:CREEL, FRANCES BROOMALL
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:BROOMALL
Last Name:CREEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:BROOMALL
Other - Last Name:LAMORTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:609 FOREST HILL CIR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-9020
Mailing Address - Country:US
Mailing Address - Phone:252-202-2615
Mailing Address - Fax:
Practice Address - Street 1:1141 N ROAD ST STE A
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3326
Practice Address - Country:US
Practice Address - Phone:252-334-9801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist