# SHELLIE R KRATZER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1700257565
- **Gender:** F
- **Credential:** CRNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | RN627395 | PA | — |
| 363L00000X | Nurse Practitioner | 024625 | PA | — |
| 363L00000X | Nurse Practitioner | SP015565 | PA | Yes |

## Other

- **Enumeration date:** 10/19/2015
- **Last updated:** 04/26/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1031720750001 | — | PA |
| 01 | — | 462444F6K | MEDICARE | PA |