Provider Demographics
NPI:1881669307
Name:FRANTZ, KITTIE (RN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:KITTIE
Middle Name:
Last Name:FRANTZ
Suffix:
Gender:F
Credentials:RN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41761
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-0761
Mailing Address - Country:US
Mailing Address - Phone:323-344-8045
Mailing Address - Fax:323-257-7209
Practice Address - Street 1:1450 10TH ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2857
Practice Address - Country:US
Practice Address - Phone:310-458-1714
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP301Medicare ID - Type Unspecified
CAP18529Medicare UPIN