Healthcare Provider Details

I. General information

NPI: 1215214820
Provider Name (Legal Business Name): SARAH ANN CRANMER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8272 MAIN STREET EXT
HAMMONDSPORT NY
14840-9701
US

IV. Provider business mailing address

8272 MAIN STREET EXT
HAMMONDSPORT NY
14840-9701
US

V. Phone/Fax

Practice location:
  • Phone: 607-569-5200
  • Fax: 607-569-5212
Mailing address:
  • Phone: 607-569-5200
  • Fax: 607-569-5212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number401260-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: