Individual
ANNA K KRAGT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
206 W. WARREN ST, MIDDLEBURY, IN 46540-0459
(574) 825-2146
(574) 524-7435
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01045002A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200101330
—
IN
01
—
236040026
MEDICARE PTAN
IN
Enumeration date
07/24/2006
Last updated
10/01/2021
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