MEDICARE: MR. JOHN A. CRANTON RN, ARNP

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
1	163W00000X	Registered Nurse	RN00121831	WA
2	363LF0000X	Family Nurse Practitioner	AP30006521	WA
3	163WC0200X	Critical Care Medicine Registered Nurse	0001134234	VA

General Provider Information

NPI Number	:	1326047986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN A. CRANTON RN, ARNP

Provider Business Mailing Address
First Line	:	15246 LEONA DR SE
Second Line	:
City	:	YELM
State	:	WA
Zip	:	98597-9067
Country	:	US
Telephone Number	:	360-894-3548
Fax Number	:

Provider Business Practice Location Address
First Line	:	15246 LEONA DR SE
Second Line	:
City	:	YELM
State	:	WA
Zip	:	98597-9067
Country	:	US
Telephone Number	:	360-894-3548
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2005
Last Update Date	:	04/28/2011

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