Healthcare Provider Details

I. General information

NPI: 1194284281
Provider Name (Legal Business Name): KELLY CRANE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 09/14/2025
Certification Date: 09/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD # 220
NEWARK DE
19718-2200
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD # 220
NEWARK DE
19718-2200
US

V. Phone/Fax

Practice location:
  • Phone: 302-623-7600
  • Fax:
Mailing address:
  • Phone: 302-623-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberC10028353
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberC10028353
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: