MEDICARE: JENNIFER ALICE KREINER NP-C

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	363LF0000X	Family Nurse Practitioner	4704218875	MI

General Provider Information

NPI Number	:	1588736433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ALICE KREINER NP-C

Provider Business Mailing Address
First Line	:	2512 WITTERS ST
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48602-3863
Country	:	US
Telephone Number	:	989-921-3072
Fax Number	:

Provider Business Practice Location Address
First Line	:	3170 SOUTH PROFESSIONAL DRIVE
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706
Country	:	US
Telephone Number	:	989-686-8782
Fax Number	:

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	07/08/2007

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