Healthcare Provider Details

I. General information

NPI: 1710043369
Provider Name (Legal Business Name): TERRI LINN CRANFIELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 FACILITY DR
CLYDE NC
28721-9438
US

IV. Provider business mailing address

35 FACILITY DR
CLYDE NC
28721-9438
US

V. Phone/Fax

Practice location:
  • Phone: 828-452-5042
  • Fax: 828-452-9225
Mailing address:
  • Phone: 828-452-5042
  • Fax: 828-452-9225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2001032204
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number6264
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberLT2646
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number50048
License Number StateWI
# 5
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number200000759
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: