Provider Demographics
NPI:1720822570
Name:CRATTY, AMY KATHERINE FLANNERY (RN)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KATHERINE FLANNERY
Last Name:CRATTY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:KATHERINE FLANNERY
Other - Last Name:SARGENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:GALESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20765-0108
Mailing Address - Country:US
Mailing Address - Phone:301-928-1756
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 108
Practice Address - Street 2:
Practice Address - City:GALESVILLE
Practice Address - State:MD
Practice Address - Zip Code:20765-0108
Practice Address - Country:US
Practice Address - Phone:301-928-1756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR136005163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse