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General NPI Number Information
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NPI Number | 1417153727
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Entity Type | Individual
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Provider Name | ELIZABETH SUZANNE CRANK MSN, APRN, RD, LD
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Gender | Female
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Dates
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Enumeration Date | 06/23/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 311 ROY CAMPBELL DR
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City | HAZARD
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State | KY
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Zip | 41701-9486
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Country | US
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Telephone | 606-487-0776
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Fax | 606-487-0777
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Provider Business Mailing Address
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Address Line | PO BOX 1297
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City | HAZARD
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State | KY
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Zip | 41702-1297
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Country | US
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Telephone | 606-487-0776
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Fax | 606-487-0777
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | KY-05-1849
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3008084
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License Number State | KY
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