Provider Demographics
NPI:1265669873
Name:KRATZ, JENNIFER JOYCE (RN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JOYCE
Last Name:KRATZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HOTHER LN
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-7622
Mailing Address - Country:US
Mailing Address - Phone:479-459-1809
Mailing Address - Fax:
Practice Address - Street 1:5 HOTHER LN
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-7622
Practice Address - Country:US
Practice Address - Phone:479-459-1809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY541147163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics