Individual provider Active NPI

Cindra McCrann, RN

  • Gerontology Registered Nurse
  • Everett, WA
National Provider Identifier
1013404417
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Registered NurseTaxonomy code 163WG0600X
License
RN60383924 Issued in WA
Practice address
3322 Broadway
Everett, WA 98201-4425
Phone
(425) 349-6800
NPI assigned
Apr 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X RN60383924 WA Primary

Addresses

Primary practice location

3322 Broadway
Everett, WA 98201-4425

Mailing address

525 125TH Ave NE
Lake Stevens, WA 98258-8179
Phone (206) 579-7948

Other identifiers 1

IdentifierTypeStateIssuer
911180810MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60383924WAMDGerontology Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1013404417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 125TH AVE NE",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982588179",
            "telephone_number": "206-579-7948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014425",
            "telephone_number": "425-349-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRANN",
        "first_name": "CINDRA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "WA",
            "license": "RN60383924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "911180810",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.