Provider Demographics
NPI:1366408320
Name:CRAY, DONNA S (DC)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:S
Last Name:CRAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DONNA
Other - Middle Name:S
Other - Last Name:FREDERICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3415 W FOX RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5204
Mailing Address - Country:US
Mailing Address - Phone:765-286-9020
Mailing Address - Fax:765-286-9097
Practice Address - Street 1:3415 W FOX RIDGE LN
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5204
Practice Address - Country:US
Practice Address - Phone:765-286-9020
Practice Address - Fax:765-286-9097
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002263A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1296287OtherAETNA
IN000000478644OtherANTHEM
IN200816880AMedicaid
IN1296287OtherAETNA
IN235950AMedicare PIN