Provider Demographics
NPI:1487086948
Name:CRANE, MARTI MCKENZIE (RPH)
Entity type:Individual
Prefix:
First Name:MARTI
Middle Name:MCKENZIE
Last Name:CRANE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MEADOWGLADES LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9740
Mailing Address - Country:US
Mailing Address - Phone:919-816-9537
Mailing Address - Fax:
Practice Address - Street 1:6911 GARRETT RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5635
Practice Address - Country:US
Practice Address - Phone:919-401-4664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist