Healthcare Provider Details

I. General information

NPI: 1144082256
Provider Name (Legal Business Name): ASHLYN MARIE KRANTZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2137 ALPINE GLEN PL
ALPINE CA
91901-2123
US

IV. Provider business mailing address

2137 ALPINE GLEN PL
ALPINE CA
91901-2123
US

V. Phone/Fax

Practice location:
  • Phone: 619-820-2523
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR1000X
TaxonomyReproductive Endocrinology/Infertility Registered Nurse
License Number95259380
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: