MEDICARE: ASHLYN MARIE KRANTZ RN

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
1	163WR1000X	Reproductive Endocrinology/Infertility Registered Nurse	95259380	CA

General Provider Information

NPI Number	:	1144082256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLYN MARIE KRANTZ RN

Provider Business Mailing Address
First Line	:	2137 ALPINE GLEN PL
Second Line	:
City	:	ALPINE
State	:	CA
Zip	:	91901-2123
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2137 ALPINE GLEN PL
Second Line	:
City	:	ALPINE
State	:	CA
Zip	:	91901-2123
Country	:	US
Telephone Number	:	619-820-2523
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2024
Last Update Date	:	01/24/2024

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