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NPI Code Detail

MEDICARE: MRS. REBECCA JEAN CRANFORD FNP-C

MEDICARE:  MRS. REBECCA JEAN CRANFORD  FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF0612248LA

General Provider Information

NPI Number : 1134475429
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA JEAN CRANFORD FNP-C
Provider Business Mailing Address
First Line : 17520 OLD JEFFERSON HWY
Second Line :
City : PRAIRIEVILLE
State : LA
Zip : 70769-3929
Country : US
Telephone Number : 225-673-8983
Fax Number : 225-677-8983
Provider Business Practice Location Address
First Line : 17520 OLD JEFFERSON HWY
Second Line :
City : PRAIRIEVILLE
State : LA
Zip : 70769-3929
Country : US
Telephone Number : 225-673-8983
Fax Number : 225-677-8983
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2012
Last Update Date : 07/24/2012

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Directions to “ MRS. REBECCA JEAN CRANFORD FNP-C” Practice Location

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