MEDICARE: MRS. SUSAN R KRATKY ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	ARNP9232726	FL

General Provider Information

NPI Number	:	1427022763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN R KRATKY ARNP

Provider Business Mailing Address
First Line	:	PO BOX 409471
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-9471
Country	:	US
Telephone Number	:	888-336-9121
Fax Number	:	561-955-1761

Provider Business Practice Location Address
First Line	:	21020 STATE ROAD 7
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33428-1320
Country	:	US
Telephone Number	:	561-883-7502
Fax Number	:	561-218-6262

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	07/08/2007

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