MR. JASON DAVID KRANENBURG (NPI# 1083046635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083046635 |
| Entity Type | Individual |
| Full Name | MR. JASON DAVID KRANENBURG |
| Credential | CSA |
| Practice Address |
170 Hayden Ct Fayetteville GA 30215-2549 |
| Practice Telephone | 9375702426 |
| Mailing Telephone | 9375702426 |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2017-02-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
143379 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
170 HAYDEN CT |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30215-2549 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801370051 | Truly Nourished, LLC | Dietitian, Registered | 500 West Lanier Ave., Suite 908, Fayetteville, GA 30215 | 2018-09-23 |
| 1104343839 | Pandora G Brown | Specialist | 65 Black Watch Ct, Fayetteville, GA 30215 | 2017-08-23 |
| 1902264492 | Ty-re Lamont Dixon Sr. | Durable Medical Equipment & Medical Supplies | 220 Shoreline Dr., Fayetteville, GA 30215 | 2016-01-29 |
| 1962870030 | Matthew Christian Alvarez | Dentist | 113 Ebenezer Rd Ste 101, Fayetteville, GA 30215 | 2015-09-08 |
| 1831534346 | Kevin Tyler Goelz | Radiology | 605 Wentworth Ct, Fayetteville, GA 30215 | 2013-05-10 |
| 1518249739 | William J. Holcomb | Pharmacist | 880 Hwy 85 South, Fayetteville, GA 30215 | 2011-09-14 |
| 1407168131 | All Care Home Health Equipment, LLC | Durable Medical Equipment & Medical Supplies | 1000 Cooper Circle, Suite 201, Fayetteville, GA 30215 | 2010-07-10 |
| 1083854160 | Rachel Blanks | Licensed Practical Nurse | 170 Brookwood Lane, Fayetteville, GA 30215 | 2009-03-02 |
| 1093964975 | Brenda Carole Hayek | Nurse Practitioner | 735 Glynn Street S, Fayetteville, GA 30215 | 2008-09-16 |
| 1174700769 | Katheryn D. Mcdonell | Counselor | 110 Dawn Drive, Fayetteville, GA 30215 | 2008-01-25 |
| Find all providers in zip 30215 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831391655 | Mandy Suzanne Mooneyham | Physician Assistant | 3053 N College Ave, Fayetteville, AR 72703-3417 | 2007-06-04 |
| 1730266453 | Mary Lee Cudd | Physician Assistant | 1774 Metromedical Drive, Fayetteville, NC 28304 | 2006-11-01 |
| 1043318611 | Dena Marie Pozeg | Physician Assistant | 4140 Ferncreek Drive, Suite 601, Fayetteville, NC 28314-2569 | 2006-09-20 |
| 1407460843 | Alexandra Paige Brown | Physician Assistant | 1695 E Rainforest Rd, Fayetteville, AR 72703-5385 | 2020-09-02 |
| 1134668007 | Gerald Crist | Physician Assistant | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2017-02-13 |
| 1477941367 | Sarah Busbin | Physician Assistant | 4140 Ferncreek Dr, Suite 801, Fayetteville, NC 28314-2563 | 2014-12-31 |
| 1265820260 | Ashley Ronk | Physician Assistant | 4140 Ferncreek Dr, Suite 801, Fayetteville, NC 28314-2563 | 2014-12-30 |
| 1275894826 | Timothy Richard Key | Physician Assistant | 115 Edenton Estates Dr, Fayetteville, GA 30214-4442 | 2012-05-30 |
| 1932258993 | Alexandra Fischell Fitzgerald | Physician Assistant | 4140 Ferncreek Dr, Suite 801, Fayetteville, NC 28314-2563 | 2007-01-09 |
| 1881767580 | Cynthia Shawn Earl | Physician Assistant | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2006-11-17 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30215 |
Please comment or provide details below to improve the information on MR. JASON DAVID KRANENBURG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.