Provider Demographics
NPI:1710205729
Name:CRANER, JEANNE MARIE
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:CRANER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 WYOLA DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-1504
Mailing Address - Country:US
Mailing Address - Phone:610-496-0725
Mailing Address - Fax:
Practice Address - Street 1:101 WALLACE AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2604
Practice Address - Country:US
Practice Address - Phone:610-873-4725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038635R183500000X
NJ28RI02161100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist