Provider Demographics
NPI:1154392793
Name:CRANE, KAREN JOAN (FNP CRNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JOAN
Last Name:CRANE
Suffix:
Gender:F
Credentials:FNP CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N ACKLAND ST
Mailing Address - Street 2:
Mailing Address - City:GAMBIER
Mailing Address - State:OH
Mailing Address - Zip Code:43022-7705
Mailing Address - Country:US
Mailing Address - Phone:740-427-5525
Mailing Address - Fax:740-427-5527
Practice Address - Street 1:221 N ACKLAND ST
Practice Address - Street 2:
Practice Address - City:GAMBIER
Practice Address - State:OH
Practice Address - Zip Code:43022-7705
Practice Address - Country:US
Practice Address - Phone:740-427-5525
Practice Address - Fax:740-427-5527
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP 07940363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2557228Medicaid
OH2557228Medicaid
OHCRNP17241Medicare ID - Type Unspecified