Provider Demographics
NPI:1205825403
Name:CRANE, PATRICIA A (MS, CNM)
Entity Type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:A
Last Name:CRANE
Suffix:
Gender:F
Credentials:MS, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 LIGNITE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3741
Mailing Address - Country:US
Mailing Address - Phone:254-291-7549
Mailing Address - Fax:
Practice Address - Street 1:1060 GAFFENY ROAD
Practice Address - Street 2:BASSETT ARMY HOSPITAL
Practice Address - City:FT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703
Practice Address - Country:US
Practice Address - Phone:907-361-5353
Practice Address - Fax:907-361-4809
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-004258367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife