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NPI Code Detail

MEDICARE: MRS. KAYLA MICHELLE KRETZER CRNP

MEDICARE: MRS. KAYLA MICHELLE KRETZER CRNP
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
1363LF0000XFamily Nurse PractitionerF06170016AL

General Provider Information

NPI Number : 1750803540
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAYLA MICHELLE KRETZER CRNP
Provider Business Mailing Address
First Line : 541 IRON MAN RD
Second Line :
City : HARTSELLE
State : AL
Zip : 35640-6609
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2941 POINT MALLARD PKWY SE STE N
Second Line :
City : DECATUR
State : AL
Zip : 35603-5760
Country : US
Telephone Number : 256-432-2822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2017
Last Update Date : 06/16/2018

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