Provider Demographics
NPI:1487164463
Name:CRANE, NADIA CRYSTAL (CNM)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:CRYSTAL
Last Name:CRANE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:NADIA
Other - Middle Name:CRYSTAL
Other - Last Name:GRAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4707 S JUNETT ST STE B
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-6480
Mailing Address - Country:US
Mailing Address - Phone:253-243-2537
Mailing Address - Fax:
Practice Address - Street 1:4707 S JUNETT ST STE B
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-6480
Practice Address - Country:US
Practice Address - Phone:253-243-2537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP10662176B00000X
OR201803248NP-PP176B00000X
WA367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife