MEDICARE: TANAE MCCRAE RN

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	RN.481785	OH
2	3747P1801X	Personal Care Attendant		OH
3	251S00000X	Community/Behavioral Health Agency
4	385H00000X	Respite Care		OH

General Provider Information

NPI Number	:	1730610353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANAE MCCRAE RN

Provider Business Mailing Address
First Line	:	2782 GROSSE PT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4877
Country	:	US
Telephone Number	:	614-597-2811
Fax Number	:

Provider Business Practice Location Address
First Line	:	2782 GROSSE PT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4877
Country	:	US
Telephone Number	:	614-597-2811
Fax Number	:

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

Provider Enumeration Date	:	03/24/2017
Last Update Date	:	12/16/2025

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