Healthcare Provider Details

I. General information

NPI: 1932876869
Provider Name (Legal Business Name): TIFFANY KRATZER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N FORGE ST
AKRON OH
44304-1407
US

IV. Provider business mailing address

2689 ALLIANCE RD
DEERFIELD OH
44411-8732
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3000
  • Fax:
Mailing address:
  • Phone: 330-428-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPRN.CNP.0029635
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: