NPI Code Details Logo

NPI 1639104276

NPI 1639104276 : ROCHELLE G MCCRANIE PA : MOULTRIE, GA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1639104276
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    ROCHELLE G MCCRANIE PA
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/12/2006
-----------------------------------------------------
    Last Update Date     |    09/04/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    8 LAUREL CT 
-----------------------------------------------------
    City                 |    MOULTRIE
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    31768-6889
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    229-890-9016
-----------------------------------------------------
    Fax                  |    229-891-9185
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 2876 
-----------------------------------------------------
    City                 |    MOULTRIE
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    31776-2876
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    229-891-9016
-----------------------------------------------------
    Fax                  |    229-891-9185
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363AM0700X
-----------------------------------------------------
    Taxonomy Name        |    Medical Physician Assistant
-----------------------------------------------------
    License Number       |    003064
-----------------------------------------------------
    License Number State |    GA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.