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General NPI Number Information
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NPI Number | 1326522319
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Entity Type | Individual
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Provider Name | SAMMY ELIZABETH KRATZER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/17/2018
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1003 HOLLAND AVE STE 103
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City | PHILADELPHIA
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State | MS
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Zip | 39350-2180
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Country | US
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Telephone | 601-482-9224
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 649105
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City | DALLAS
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State | TX
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Zip | 75264-9105
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Country | US
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Telephone | 601-207-7093
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 902902
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License Number State | MS
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