Individual provider · Type 1 NPI

Matthew McCracken

Gerontology Nurse Practitioner · Indianapolis, IN

NPI number 1104579770 Active

Practice location

8111 S Emerson Ave Fl 5
Indianapolis, IN 46237-8601

Fax (317) 528-8532

Mailing address

PO Box 781076
Detroit, MI 48278-1076

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600X71012225A (IN)
Nurse Practitioner 363L00000X28157506A (IN)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1104579770

Matthew McCracken's National Provider Identifier is 1104579770, issued on Feb 2, 2022. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Indianapolis, IN. The record was last updated on Oct 11, 2023.