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General NPI Number Information
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NPI Number | 1821609603
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Entity Type | Individual
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Provider Name | REBEKKAH CRATTY MCGRONAN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 1805 W CITY DR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-9646
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Country | US
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Telephone | 252-334-1602
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Fax | 252-334-1604
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Provider Business Mailing Address
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Address Line | PO BOX 11314
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City | BELFAST
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State | ME
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Zip | 04915-4004
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Country | US
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Telephone | 757-842-4481
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Fax | 757-312-3135
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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 | F07201662
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License Number State | NC
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