Provider Demographics
NPI:1689290868
Name:CRANE, ALICIA LYNN
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:LYNN
Last Name:CRANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:LYNN
Other - Last Name:CRANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 173560
Mailing Address - Street 2:ANNA PEARL SHERRICK HALL
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59717-3560
Mailing Address - Country:US
Mailing Address - Phone:406-994-3597
Mailing Address - Fax:
Practice Address - Street 1:1 ANNA PEARL SHERRICK HALL
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59717-3560
Practice Address - Country:US
Practice Address - Phone:406-994-3597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program