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General NPI Number Information
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NPI Number | 1780017343
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Entity Type | Individual
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Provider Name | MARY MAXINE MCCRARY APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/18/2013
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 563 COLONIAL DR
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City | BATON ROUGE
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State | LA
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Zip | 70806-6508
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Country | US
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Telephone | 225-505-5217
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Fax | 225-452-9123
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Provider Business Mailing Address
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Address Line | 17625 WISDOM DR
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City | BAKER
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State | LA
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Zip | 70714-1536
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Country | US
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Telephone | 225-505-5217
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Fax | 225-452-9123
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP07509
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License Number State | LA
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