Provider Demographics
NPI:1780731844
Name:CRANDALL, KERRY ANNE (ARNP)
Entity type:Individual
Prefix:MS
First Name:KERRY
Middle Name:ANNE
Last Name:CRANDALL
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:75 KNOLLWOOD ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4220
Mailing Address - Country:US
Mailing Address - Phone:386-852-8505
Mailing Address - Fax:386-677-5686
Practice Address - Street 1:266 N NOVA RD # 344
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5124
Practice Address - Country:US
Practice Address - Phone:386-852-8505
Practice Address - Fax:888-435-0422
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2019-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP2043932363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology