Provider Demographics
NPI:1194092791
Name:MCCRANIE, MICHELE COLLEEN (AP)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:COLLEEN
Last Name:MCCRANIE
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14685 PINE DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3726
Mailing Address - Country:US
Mailing Address - Phone:727-410-7698
Mailing Address - Fax:
Practice Address - Street 1:10333 SEMINOLE BLVD
Practice Address - Street 2:SUITE #5
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33778-4210
Practice Address - Country:US
Practice Address - Phone:727-410-7698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-27
Last Update Date:2011-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3003171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist