Healthcare Provider Details

I. General information

NPI: 1730205907
Provider Name (Legal Business Name): SHARON CRANE N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6920 GATWICK DR SUITE 100
INDIANAPOLIS IN
46241-9504
US

IV. Provider business mailing address

3684 N RUSSELL RD
BLOOMINGTON IN
47408-9217
US

V. Phone/Fax

Practice location:
  • Phone: 317-856-2945
  • Fax: 317-856-5122
Mailing address:
  • Phone: 812-331-4176
  • Fax: 812-331-4176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71001606A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: