Provider Demographics
NPI:1679674634
Name:CRANE, QUINCY NOELLE (MMS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:QUINCY
Middle Name:NOELLE
Last Name:CRANE
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 E HARMONY RD UNIT 370
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3404
Mailing Address - Country:US
Mailing Address - Phone:970-221-2290
Mailing Address - Fax:970-295-0036
Practice Address - Street 1:2121 E HARMONY RD
Practice Address - Street 2:SUITE 370
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528
Practice Address - Country:US
Practice Address - Phone:970-221-2290
Practice Address - Fax:970-221-2293
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2312363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program