Provider Demographics
NPI:1568631117
Name:KRANZ, KARRIE E (PA)
Entity Type:Individual
Prefix:
First Name:KARRIE
Middle Name:E
Last Name:KRANZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-6114
Mailing Address - Country:US
Mailing Address - Phone:269-375-0400
Mailing Address - Fax:269-372-8484
Practice Address - Street 1:6565 W MAIN ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-6114
Practice Address - Country:US
Practice Address - Phone:269-375-0400
Practice Address - Fax:269-372-8484
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601002570363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5601002570OtherMICHIGAN LICENSE