Provider Demographics
NPI:1730520487
Name:CREAGER, KRYSTAL (BS)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:
Last Name:CREAGER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BANNOCK RD
Mailing Address - Street 2:UNIT A
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001
Mailing Address - Country:US
Mailing Address - Phone:303-885-9857
Mailing Address - Fax:
Practice Address - Street 1:2000 WESTLAND RD UNIT C
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3309
Practice Address - Country:US
Practice Address - Phone:307-761-1993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator