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General NPI Number Information
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NPI Number | 1477498178
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Entity Type | Individual
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Provider Name | ELLIE R MCCRACKEN RN
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Gender | Female
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 364 MURPHYS GRADE RD
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City | ANGELS CAMP
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State | CA
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Zip | 95222-9133
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Country | US
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Telephone | 209-736-8381
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Fax | 209-736-8383
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Provider Business Mailing Address
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Address Line | 323 S MAIN ST PO BOX 7000/21
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City | ANGELS CAMP
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State | CA
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Zip | 95221
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Country | US
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Telephone | 209-736-8381
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Fax | 209-736-8383
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 768111
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License Number State | CA
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