Healthcare Provider Details

I. General information

NPI: 1083553531
Provider Name (Legal Business Name): MADISEN KRATZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 W 15TH ST FL 3
LAWRENCE KS
66045-7608
US

IV. Provider business mailing address

2201 E TRACY LN
SIOUX FALLS SD
57103-0768
US

V. Phone/Fax

Practice location:
  • Phone: 785-864-4720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: