Provider Demographics
NPI:1144756545
Name:CRANFORD, ANNDI (CNP)
Entity Type:Individual
Prefix:
First Name:ANNDI
Middle Name:
Last Name:CRANFORD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 PUTTER CV
Mailing Address - Street 2:
Mailing Address - City:MAYFLOWER
Mailing Address - State:AR
Mailing Address - Zip Code:72106-8425
Mailing Address - Country:US
Mailing Address - Phone:870-904-9863
Mailing Address - Fax:501-686-8644
Practice Address - Street 1:501 JACK STEPHENS DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5551
Practice Address - Country:US
Practice Address - Phone:501-686-5878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005144363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily