Doctor Name: | JESSE MICHAEL CRANE |
NPI Number: | 1548520505 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 2920 N 4th St Flagstaff, AZ - 860041816 |
Business Phone Number: | 9287749428 |
Business Fax Number: | |
Mailing Address: | 2475 E Elder Dr, FLAGSTAFF |
State: | AZ |
Postal Code: | 860041835 |
Phone Number: | 9286375139 |
Fax Number: | |
NPI Enumeration Date: | 05/24/2012 |
NPI Last Update Date: | 09/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |