Healthcare Provider Details

I. General information

NPI: 1649987447
Provider Name (Legal Business Name): PRANVERA KRAKOWER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7A TOSCH AVE
WAYNE NJ
07470-3030
US

IV. Provider business mailing address

7A TOSCH AVE
WAYNE NJ
07470-3030
US

V. Phone/Fax

Practice location:
  • Phone: 973-870-1442
  • Fax:
Mailing address:
  • Phone: 973-870-1442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ01374300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: