Provider Demographics
NPI:1396283461
Name:FRANZEN, CRYSTAL ANN (RN)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ANN
Last Name:FRANZEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:ANN
Other - Last Name:KALIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1177
Mailing Address - Street 2:926 SOUTH 8TH STREET
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54221-1177
Mailing Address - Country:US
Mailing Address - Phone:920-683-4230
Mailing Address - Fax:920-683-4908
Practice Address - Street 1:926 SOUTH 8TH STREET
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54221-1177
Practice Address - Country:US
Practice Address - Phone:920-683-4230
Practice Address - Fax:920-683-4908
Is Sole Proprietor?:No
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI232389-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse