Provider Demographics
NPI:1609107408
Name:CRANK, AMY D (CRNA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:D
Last Name:CRANK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:D
Other - Last Name:DALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 HOLLAND DR
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4048
Mailing Address - Country:US
Mailing Address - Phone:214-903-9787
Mailing Address - Fax:
Practice Address - Street 1:13601 PRESTON RD
Practice Address - Street 2:STE 1000W
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4911
Practice Address - Country:US
Practice Address - Phone:972-663-8523
Practice Address - Fax:972-663-8329
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX679937367500000X
OK95279367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210740102Medicaid
OK200350010AMedicaid
TX8807UBOtherBCBS
TXP00983545OtherRAILROAD
TX210740102Medicaid
TXP00983545OtherRAILROAD