Individual
KATHY J. KRANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 387-7170
Mailing address
PO BOX 2429, SMYRNA, TN 37167-1719
(615) 355-3451
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A01620ANP
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146677758
—
AR
05
—
200122640 A
—
OK
05
—
427470901
—
MO
01
—
500021404
RAILROAD PROVIDER NUMBER
AR
01
—
5W770
BLUECROSS BLUESHIELD
AR
Enumeration date
06/01/2007
Last updated
09/03/2019
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