Basic Information
Provider Information
NPI: 1730558826
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KREITZER
FirstName: BARBARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: AGNP
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 117287
Address2:  
City: ATLANTA
State: GA
PostalCode: 303687287
CountryCode: US
TelephoneNumber: 8662660555
FaxNumber: 8662664999
Practice Location
Address1: 300 ASHVILLE AVE STE 310
Address2:  
City: CARY
State: NC
PostalCode: 275188682
CountryCode: US
TelephoneNumber: 9192338585
FaxNumber: 9192338566
Other Information
ProviderEnumerationDate: 09/18/2015
LastUpdateDate: 11/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LG0600X5007840NCN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
363L00000X5007840NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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