Provider Demographics
NPI:1710043369
Name:CRANFIELD, TERRI LINN (MD)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LINN
Last Name:CRANFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 FACILITY DR
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-9438
Mailing Address - Country:US
Mailing Address - Phone:828-452-5042
Mailing Address - Fax:828-452-9225
Practice Address - Street 1:35 FACILITY DR
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-9438
Practice Address - Country:US
Practice Address - Phone:828-452-5042
Practice Address - Fax:828-452-9225
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001032204207V00000X
AK6264207V00000X
NHLT2646207V00000X
WI50048207V00000X
NC200000759207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30207196Medicaid
AKK161564Medicare PIN
NH30207196Medicaid
NH000298401Medicare PIN