Provider Demographics
NPI:1073246138
Name:BARANCZYK, KAY SUSAN (APNP)
Entity type:Individual
Prefix:MS
First Name:KAY
Middle Name:SUSAN
Last Name:BARANCZYK
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:SUSAN
Other - Last Name:HARTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:301 EXPLORER ST
Mailing Address - Street 2:
Mailing Address - City:GWINN
Mailing Address - State:MI
Mailing Address - Zip Code:49841-2813
Mailing Address - Country:US
Mailing Address - Phone:906-290-5000
Mailing Address - Fax:906-372-3230
Practice Address - Street 1:1110 10TH AVE
Practice Address - Street 2:
Practice Address - City:MENOMINEE
Practice Address - State:MI
Practice Address - Zip Code:49858-3058
Practice Address - Country:US
Practice Address - Phone:906-290-5000
Practice Address - Fax:906-372-3230
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704423090363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F06220244OtherAANP