Provider Demographics
NPI:1942578927
Name:DORWART CRANE, ANDREA BONNIE (RN, CNM)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:BONNIE
Last Name:DORWART CRANE
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 BARRANCA PKWY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4733
Mailing Address - Country:US
Mailing Address - Phone:949-654-2727
Mailing Address - Fax:
Practice Address - Street 1:4650 BARRANCA PKWY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4733
Practice Address - Country:US
Practice Address - Phone:949-654-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA808203163W00000X
CA1979367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse