| Doctor Name: | NICOLE MCCRACKIN |
| NPI Number: | 1902273378 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP-BC |
| License Number: | COA.16717-NP |
| Business Practice Address: | 11781 State Route 762 Orient, OH - 431469008 |
| Business Phone Number: | 6148774362 |
| Business Fax Number: | |
| Mailing Address: | 11781 State Route 762, P.o. Box 209 ORIENT |
| State: | OH |
| Postal Code: | 431469008 |
| Phone Number: | 6148774362 |
| Fax Number: | |
| NPI Enumeration Date: | 09/01/2015 |
| NPI Last Update Date: | 09/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | COA.16717-NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |