Provider Demographics
NPI:1982664231
Name:MCCRANIE, KATHY F (MD)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:F
Last Name:MCCRANIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1380 S SANTA FE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-3260
Mailing Address - Country:US
Mailing Address - Phone:303-777-3422
Mailing Address - Fax:303-777-3425
Practice Address - Street 1:1380 S SANTA FE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-3260
Practice Address - Country:US
Practice Address - Phone:303-777-3422
Practice Address - Fax:303-777-3425
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO306452081P2900X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO33089833Medicaid
COMC14614OtherBLUE CROSS BLUE SHIELD
CO806266Medicare Oscar/Certification
COF21108Medicare UPIN