Provider Demographics
NPI:1144659533
Name:CRANAGE, ANDREA LYNN (RN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNN
Last Name:CRANAGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-2744
Mailing Address - Country:US
Mailing Address - Phone:607-231-8364
Mailing Address - Fax:607-772-9779
Practice Address - Street 1:355 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2744
Practice Address - Country:US
Practice Address - Phone:607-231-8364
Practice Address - Fax:607-772-9779
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY518292-1163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator