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NPI Code Detail

MEDICARE: MR. GREGORY J MCCRACKEN CRNA

MEDICARE: MR. GREGORY J MCCRACKEN CRNA
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
1367500000XCertified Registered Nurse AnesthetistARNP2735182FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275632911
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GREGORY J MCCRACKEN CRNA
Provider Business Mailing Address
First Line : 3955 INDIAN RIVER BLVD STE 100
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4845
Country : US
Telephone Number : 772-569-2330
Fax Number : 772-569-2630
Provider Business Practice Location Address
First Line : 3955 INDIAN RIVER BLVD STE 100
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4845
Country : US
Telephone Number : 772-569-2330
Fax Number : 772-569-2630
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 01/14/2026

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