Provider Demographics
NPI:1902892722
Name:MCCRACKEN, JONNA RICE (NP)
Entity Type:Individual
Prefix:
First Name:JONNA
Middle Name:RICE
Last Name:MCCRACKEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:JONNA
Other - Middle Name:KATHRYNE
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4230 HARDING RD
Mailing Address - Street 2:STE 307
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2013
Mailing Address - Country:US
Mailing Address - Phone:615-292-8299
Mailing Address - Fax:615-385-7993
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:STE 307
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-292-8299
Practice Address - Fax:615-385-7993
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6750363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341187Medicare PIN