Provider Demographics
NPI:1851126890
Name:KRATZ, ANNIE RENEE
Entity type:Individual
Prefix:MS
First Name:ANNIE
Middle Name:RENEE
Last Name:KRATZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 PIONEER WAY
Mailing Address - Street 2:
Mailing Address - City:TAHOE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:96145-1808
Mailing Address - Country:US
Mailing Address - Phone:530-448-7108
Mailing Address - Fax:
Practice Address - Street 1:380 PIONEER WAY
Practice Address - Street 2:
Practice Address - City:TAHOE CITY
Practice Address - State:CA
Practice Address - Zip Code:96145-1808
Practice Address - Country:US
Practice Address - Phone:530-448-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program