Provider Demographics
NPI:1730487968
Name:MCCRACKEN, MELISSA (RN)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:
Last Name:MCCRACKEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 AIRPORT HEIGHTS DR
Mailing Address - Street 2:SUITE 278
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2965
Mailing Address - Country:US
Mailing Address - Phone:907-929-4263
Mailing Address - Fax:
Practice Address - Street 1:1200 AIRPORT HEIGHTS DR
Practice Address - Street 2:SUITE 278
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2965
Practice Address - Country:US
Practice Address - Phone:907-929-4263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK30156163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse