Susan E Crane

Individual provider Active NPI Community Health Registered Nurse · Bunnell, FL

NPI 1225879042 · NPPES record last updated Jun 5, 2024

Key facts

NPI
1225879042
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
9176842 (FL)
Practice address
301 Dr Carter Blvd
Bunnell, FL 32110-6212
Phone
(386) 437-7350
Fax
(386) 437-7353
NPI assigned
Jun 5, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
9176842FLMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse
Group: 193200000X MULTI-SPECIALTY GROUP
163WC1500X 9176842 FL Yes

Addresses

Primary practice location

301 Dr Carter Blvd
Bunnell, FL 32110-6212

Mailing address

301 Dr Carter Blvd
Bunnell, FL 32110-6212
Phone (386) 437-7350

Other providers in Bunnell, FL

All providers in Bunnell, FL · Community Health Registered Nurse in Florida

Sources for this page

Verify at the official NPI Registry.