Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | SP007768 | PA |
Y | 363LA2200X | Nurse Practitioner - Adult Health | SP007768 | PA |
N | 363LG0600X | Nurse Practitioner - Gerontology | SP007767 | PA |
NPI | 1073503066 |
---|---|
Provider Name | Mrs. Heather Christine Kratz |
First Address | Plymouth Meeting, PA 19462-2324 |
Second Address | Plymouth Meeting, PA 19462 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 20/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07820564 | (05) | PA |
233049357 | TAX ID (01) | PA |
P84323 | (02) | PA |