Dale M Kraenzle, FNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

63676 Issued in MO

Practice address

930 Park Dr
Ste Genevieve, MO 63670-1539

Phone

(573) 883-4477

Fax

(573) 883-4472

NPI assigned

Jan 15, 2007

Last updated

Apr 18, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ste Genevieve County Memorial Hospital

  dba Family Heath Care Pointe Basse

  • Rural Health Clinic/Center
  • Ste Genevieve, MO
  • NPI 1801817416
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1437200649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 PARK DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636700366",
            "telephone_number": "573-883-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 PARK DR",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701539",
            "telephone_number": "573-883-4477",
            "fax_number": "573-883-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAENZLE",
        "first_name": "DALE",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "63676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL HEALTH CLINIC",
            "identifier": "263439",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Elizabeth Kertz, MD
• Klein Eye Care I, Inc
• Michael A Kolda, M.D.
• Casey Koller
• Henry Joseph Konzelmann, M.D.
• Jenna Kuehn, PTA
• Roland B Kuenzel, DC
• Courtney Kwan
• Tony C Lam, MD
• Erika Leung, M.D.

• Adult Health Nurse Practitioner in Ste Genevieve, MO
• Providers in Ste Genevieve, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.