MEDICARE: SUSAN L MCCRACKEN 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	363L00000X	Nurse Practitioner	ARNP2223382	FL

General Provider Information

NPI Number	:	1376977447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN L MCCRACKEN ARNP

Provider Business Mailing Address
First Line	:	PO BOX 740177
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33474-0177
Country	:	US
Telephone Number	:	561-740-2900
Fax Number	:	561-740-2901

Provider Business Practice Location Address
First Line	:	6135 LAKE WORTH RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3074
Country	:	US
Telephone Number	:	561-740-2900
Fax Number	:	561-434-4618

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

Provider Enumeration Date	:	08/26/2013
Last Update Date	:	04/19/2018

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