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NPI Code Detail

MEDICARE: FRANCES KRISTINE KETZ PHD

MEDICARE: FRANCES KRISTINE KETZ PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist07-20PAR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20178479OTHERWAL & I

General Provider Information

NPI Number : 1043299332
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRANCES KRISTINE KETZ PHD
Provider Business Mailing Address
First Line : 108 N SHACKLEFORD RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-2840
Country : US
Telephone Number : 501-346-8116
Fax Number :
Provider Business Practice Location Address
First Line : 108 N SHACKLEFORD RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-2840
Country : US
Telephone Number : 501-346-8116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2006
Last Update Date : 11/22/2023

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