Provider Demographics
NPI:1720465792
Name:CRANK, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:CRANK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74402-1267
Mailing Address - Country:US
Mailing Address - Phone:918-463-2581
Mailing Address - Fax:918-463-2585
Practice Address - Street 1:1002 CAMBELL ST
Practice Address - Street 2:
Practice Address - City:WARNER
Practice Address - State:OK
Practice Address - Zip Code:74469
Practice Address - Country:US
Practice Address - Phone:918-463-2581
Practice Address - Fax:918-463-2585
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator