MEDICARE: KATHY F. MCCRANIE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	30645	CO
2	208100000X	Physical Medicine & Rehabilitation Physician	30645	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MC14614	OTHER	CO	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1982664231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY F. MCCRANIE M.D.

Provider Business Mailing Address
First Line	:	1380 S SANTA FE DR
Second Line	:	SUITE 100
City	:	DENVER
State	:	CO
Zip	:	80223-3260
Country	:	US
Telephone Number	:	303-777-3422
Fax Number	:	303-777-3425

Provider Business Practice Location Address
First Line	:	1380 S SANTA FE DR
Second Line	:	SUITE 100
City	:	DENVER
State	:	CO
Zip	:	80223-3260
Country	:	US
Telephone Number	:	303-777-3422
Fax Number	:	303-777-3425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	08/09/2007

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