Provider Demographics
NPI:1477723989
Name:KRANZ, JACK W (RN)
Entity Type:Individual
Prefix:MR
First Name:JACK
Middle Name:W
Last Name:KRANZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6706 E CASTLETON RD
Mailing Address - Street 2:
Mailing Address - City:HAVEN
Mailing Address - State:KS
Mailing Address - Zip Code:67543-8552
Mailing Address - Country:US
Mailing Address - Phone:620-465-3486
Mailing Address - Fax:
Practice Address - Street 1:6706 E CASTLETON RD
Practice Address - Street 2:
Practice Address - City:HAVEN
Practice Address - State:KS
Practice Address - Zip Code:67543-8552
Practice Address - Country:US
Practice Address - Phone:620-465-3486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-72905-042163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency