Provider Demographics
NPI:1740790849
Name:CRANK, MADELINE CLAIRE (PNP)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:CLAIRE
Last Name:CRANK
Suffix:
Gender:
Credentials:PNP
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 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6483
Mailing Address - Fax:682-885-3113
Practice Address - Street 1:4200 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9805
Practice Address - Country:US
Practice Address - Phone:682-303-4200
Practice Address - Fax:682-303-4242
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134741163W00000X, 163WM0102X, 363LP0200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics