Provider Demographics
NPI:1780307850
Name:MCCRACKEN, LINDA GRACE (PA-C)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:GRACE
Last Name:MCCRACKEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:GRACE
Other - Last Name:HOLDEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:114 FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1333
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 N NEW CASTLE ST
Practice Address - Street 2:
Practice Address - City:NEW WILMINGTON
Practice Address - State:PA
Practice Address - Zip Code:16142-1019
Practice Address - Country:US
Practice Address - Phone:724-946-3564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA063994363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant