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NPI Code Detail

MEDICARE: MRS. MELISSA RAE MCCRAY

MEDICARE: MRS. MELISSA RAE MCCRAY
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
1363L00000XNurse Practitioner71018092AIN
2363L00000XNurse PractitionerAPRN11018811FL
3363LF0000XFamily Nurse PractitionerAPRN.CNP.13694OH
4363LF0000XFamily Nurse PractitionerA190285IA
5363L00000XNurse PractitionerAPRN.CNP.13694OH

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 : 1972866424
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELISSA RAE MCCRAY
Provider Business Mailing Address
First Line : 500 KIRTS BLVD STE 100
Second Line :
City : TROY
State : MI
Zip : 48084-4135
Country : US
Telephone Number : 248-434-6169
Fax Number : 855-618-6655
Provider Business Practice Location Address
First Line : 8600 HIDDEN RIVER PKWY STE 75
Second Line :
City : TAMPA
State : FL
Zip : 33637-1113
Country : US
Telephone Number : 813-517-0137
Fax Number : 877-396-5962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2012
Last Update Date : 06/11/2026

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Directions to “ MRS. MELISSA RAE MCCRAY ” Practice Location

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