Provider Demographics
NPI:1922104504
Name:SONDRA KRAYCA, A.R.N.P., LLC
Entity Type:Organization
Organization Name:SONDRA KRAYCA, A.R.N.P., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ARNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAYCA
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:785-890-7950
Mailing Address - Street 1:910 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GOODLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67735-2941
Mailing Address - Country:US
Mailing Address - Phone:785-890-7950
Mailing Address - Fax:785-890-7951
Practice Address - Street 1:910 MAIN ST
Practice Address - Street 2:
Practice Address - City:GOODLAND
Practice Address - State:KS
Practice Address - Zip Code:67735-2941
Practice Address - Country:US
Practice Address - Phone:785-890-7950
Practice Address - Fax:785-890-7951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74225363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS161557Medicare ID - Type Unspecified
KSR93271Medicare UPIN