Provider Demographics
NPI:1982713053
Name:CRANE, MONICA K (MD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:K
Last Name:CRANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1731 SAINT PETERSBURG ROAD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922
Mailing Address - Country:US
Mailing Address - Phone:215-840-4020
Mailing Address - Fax:865-444-7672
Practice Address - Street 1:1400 DOWELL SPRINGS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2457
Practice Address - Country:US
Practice Address - Phone:865-888-9494
Practice Address - Fax:865-444-7672
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00402207QG0300X
TN42587207QG0300X
TNMD00000-42587207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1506806Medicaid
NC5905227Medicaid
TN4159913Medicaid
NC2063968Medicare ID - Type UnspecifiedSENIOR HEALTH
TN1506806Medicaid
NC5905227Medicaid