Provider Demographics
NPI:1922094978
Name:CRANE, GAIL A (PA-C)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:A
Last Name:CRANE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9055 SW 103RD PL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-9549
Mailing Address - Country:US
Mailing Address - Phone:928-660-2504
Mailing Address - Fax:
Practice Address - Street 1:2955 SE 3RD CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0441
Practice Address - Country:US
Practice Address - Phone:800-210-2736
Practice Address - Fax:800-210-2758
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9107695363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ989626Medicaid
AZQ60910Medicare UPIN
AZ989626Medicaid