Healthcare Provider Details

I. General information

NPI: 1104742246
Provider Name (Legal Business Name): DEBRA R KRANER L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E STATE ST STE B
HAMEL IL
62046-1085
US

IV. Provider business mailing address

105 E STATE STREET, STE B PO BOX 305
HAMEL IL
62046
US

V. Phone/Fax

Practice location:
  • Phone: 618-633-2026
  • Fax:
Mailing address:
  • Phone: 618-633-2026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198.011914
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: