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MR. ERIC ASHLEY MCCRANEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
1017 JACKSON AVE, LEAKESVILLE, MS 39451-9105
(601) 947-1330
(601) 947-1331
Mailing address
PO BOX 1007, LUCEDALE, MS 39452-1007
(251) 690-8891
(251) 544-0188

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1-092412
AL
363LF0000X
Family Nurse Practitioner
Primary
R863289
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011846
MEDICARE GROUP NUMBER
AL
05
05523153
MS
01
1063439065
NPI SITE GROUP PAYEE NUMBER
AL
05
630000013
AL
Enumeration date
03/17/2008
Last updated
12/27/2012
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