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Porter Crandell
Student in an Organized Health Care Education/Training Program in Kirksville, Missouri
NPI 1043072564

Porter Crandell is a Student in an Organized Health Care Education/Training Program based in Show Low, MO. Porter Crandell practices in Kirksville, MO. The NPI Number for Porter Crandell is 1043072564 and holds a License No. (Missouri).

The current practice location address for Porter Crandell is 800 W Jefferson St, Kirksville, MO and can be reached out via phone at 928-207-5621.

Location: 800 W Jefferson St, Kirksville, MO, 85901-2915
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043072564
Provider Name
Porter Crandell
Credential
Provider Entity Type
Individual
Gender
Male
Address
800 W Jefferson St, Kirksville, MO, 85901-2915
Phone Number
928-207-5621
Fax Number
Provider Enumeration Date
01/29/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
800 W Jefferson St
City
Kirksville
State
Missouri
Zip
63501-1443
Phone Number
928-207-5621
Fax Number
person
Provider Business Mailing Address Details
Address
800 W Jefferson St
City
Kirksville
State
Missouri
Zip
63501-1443
Phone Number
928-207-5621
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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