Provider Demographics
NPI:1184813420
Name:MCCRAY, MARIAN S (APRN-BC)
Entity type:Individual
Prefix:
First Name:MARIAN
Middle Name:S
Last Name:MCCRAY
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3204
Mailing Address - Country:US
Mailing Address - Phone:864-232-1470
Mailing Address - Fax:864-233-4599
Practice Address - Street 1:600 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3204
Practice Address - Country:US
Practice Address - Phone:864-232-1470
Practice Address - Fax:864-233-4599
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3200363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health