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Individual

MARY KATHLEEN MCCRACKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2017022598
WV
363L00000X
Nurse Practitioner
Primary
APRN.CNP.021969
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0275191
OH
Enumeration date
12/20/2017
Last updated
05/29/2020
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