Provider Demographics
NPI:1194918003
Name:FRATZKE, BARRY A (RN)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:A
Last Name:FRATZKE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29648 COUNTY ROAD 50
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:MN
Mailing Address - Zip Code:56320-9616
Mailing Address - Country:US
Mailing Address - Phone:320-685-4100
Mailing Address - Fax:
Practice Address - Street 1:29648 COUNTY ROAD 50
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:MN
Practice Address - Zip Code:56320-9616
Practice Address - Country:US
Practice Address - Phone:320-685-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 083781-7163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse