Provider Demographics
NPI:1316495500
Name:KRANTZ, MISSOURI (NP-C)
Entity type:Individual
Prefix:
First Name:MISSOURI
Middle Name:
Last Name:KRANTZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 SAN JUAN AVE
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-3323
Mailing Address - Country:US
Mailing Address - Phone:719-363-1533
Mailing Address - Fax:719-363-1534
Practice Address - Street 1:2215 SAN JUAN AVE
Practice Address - Street 2:
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050-3323
Practice Address - Country:US
Practice Address - Phone:719-363-1533
Practice Address - Fax:719-363-1534
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0992545363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care