Provider Demographics
NPI:1942557517
Name:CRANER, TINA (DEM)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:CRANER
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:MARTINA
Other - Middle Name:
Other - Last Name:CRANER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DEM
Mailing Address - Street 1:2244 W 600 N
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-9442
Mailing Address - Country:US
Mailing Address - Phone:801-309-5163
Mailing Address - Fax:
Practice Address - Street 1:2244 W 600 N
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-9442
Practice Address - Country:US
Practice Address - Phone:801-309-5163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife