Provider Demographics
NPI:1164674792
Name:KRANENBURG, EDNA MILENA (LM)
Entity Type:Individual
Prefix:MRS
First Name:EDNA
Middle Name:MILENA
Last Name:KRANENBURG
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 S CURLEW LN
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-1058
Mailing Address - Country:US
Mailing Address - Phone:305-338-0348
Mailing Address - Fax:305-274-8825
Practice Address - Street 1:1707 S CURLEW LN
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-1058
Practice Address - Country:US
Practice Address - Phone:305-338-0348
Practice Address - Fax:305-274-8825
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW174176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife