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General NPI Number Information
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NPI Number | 1124908785
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE NEUROPHYSIOLOGY D/B/A ALTMED, LLC
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 2099 N MOUNT JULIET RD UNIT 112
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City | MT JULIET
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State | TN
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Zip | 37122-3405
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Country | US
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Telephone | 850-860-5566
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Fax |
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Provider Business Mailing Address
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Address Line | 2099 N MOUNT JULIET RD UNIT 112
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City | MT JULIET
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State | TN
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Zip | 37122-3405
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Country | US
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Telephone | 850-860-5566
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SEAN F MCCRACKEN
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Credential | PHD, APRN-C(NT), MBA
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Telephone | 850-860-5566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LC0200X
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Taxonomy Name | Critical Care Medicine Nurse Practitioner
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License Number |
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License Number State |
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