Provider Demographics
NPI:1871771469
Name:CRANE, STEPHANIE ANGELA (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANGELA
Last Name:CRANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ANGELA
Other - Last Name:MONROE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5675 ROE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:ROELAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2538
Mailing Address - Country:US
Mailing Address - Phone:991-343-2208
Mailing Address - Fax:913-432-5183
Practice Address - Street 1:9300 MEADOWVIEW DR.
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66109-7288
Practice Address - Country:US
Practice Address - Phone:913-299-3700
Practice Address - Fax:913-299-3700
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0436127207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ524715Medicaid