Provider Demographics
NPI:1144635780
Name:MCCRANEY, DONNA PAIGE (ARNP)
Entity type:Individual
Prefix:
First Name:DONNA PAIGE
Middle Name:
Last Name:MCCRANEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 E HELEN CIR
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-7418
Mailing Address - Country:US
Mailing Address - Phone:863-537-0966
Mailing Address - Fax:
Practice Address - Street 1:111 LAKE HOLLINGSWORTH DRIVE
Practice Address - Street 2:FLORIDA SOUTHERN COLLEGE STUDENT HEALTH CENTER
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801
Practice Address - Country:US
Practice Address - Phone:863-680-4292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1372322363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health