Healthcare Provider Details

I. General information

NPI: 1457340879
Provider Name (Legal Business Name): PAMELA W CRANCE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 S MAGNOLIA AVE
WAYNESBORO VA
22980-3629
US

IV. Provider business mailing address

213 S JEFFERSON ST STE 1006
ROANOKE VA
24011-1713
US

V. Phone/Fax

Practice location:
  • Phone: 540-949-8241
  • Fax: 540-949-5582
Mailing address:
  • Phone: 540-224-5372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024165932
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: