Provider Demographics
NPI:1588470561
Name:CRANE, JENNIFER LYNN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:CRANE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 CICARA WAY
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-1239
Mailing Address - Country:US
Mailing Address - Phone:304-992-1876
Mailing Address - Fax:
Practice Address - Street 1:149 GOHEEN ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-1661
Practice Address - Country:US
Practice Address - Phone:304-520-0182
Practice Address - Fax:304-647-5373
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-05
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist