Provider Demographics
NPI:1093506297
Name:MCCRACKEN, ANDREA PERSEPHONE (FNP-C)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:PERSEPHONE
Last Name:MCCRACKEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 STAMFORD DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2723
Mailing Address - Country:US
Mailing Address - Phone:302-893-2754
Mailing Address - Fax:302-893-2754
Practice Address - Street 1:305 STAMFORD DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-2723
Practice Address - Country:US
Practice Address - Phone:302-893-2754
Practice Address - Fax:302-893-2754
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0013228363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily