Sara Ashley McCracken

Individual provider Active NPI Family Nurse Practitioner · Estill, SC

NPI 1639684657 · NPPES record last updated Dec 13, 2017

Key facts

NPI
1639684657
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
21497 (SC)
Practice address
776 2ND St E
Estill, SC 29918-4926
Phone
(803) 625-2548
Fax
(803) 625-2801
NPI assigned
Dec 13, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21497 SC Yes

Addresses

Primary practice location

776 2ND St E
Estill, SC 29918-4926

Mailing address

PO Box 357
Ridgeland, SC 29936-2605

Other identifiers

IdentifierTypeStateIssuer
21497OtherSCSTATE LICENSE

Other providers in Estill, SC

All providers in Estill, SC · Family Nurse Practitioner in South Carolina

Sources for this page

Verify at the official NPI Registry.