Individual
CAROLYN RENE PETRENCIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
716 N HIGHWAY 67 STE 2, CEDAR HILL, TX 75104-2117
(972) 291-9165
Mailing address
3408 VISTA LAKE CIR, MANSFIELD, TX 76063-5834
(817) 919-9434
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1070718
TX
363LF0000X
Family Nurse Practitioner
1070718
TX
Other
Enumeration date
02/12/2022
Last updated
10/10/2024
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