Individual
ZACHARY KROENKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC, APRN
Contact information
Practice address
12685 N PEACH BLOSSOM CT, PLATTE CITY, MO 64079-4519
(402) 770-2070
Mailing address
12685 N PEACH BLOSSOM CT, PLATTE CITY, MO 64079-4519
(402) 770-2070
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2019029494
MO
363L00000X
Nurse Practitioner
Primary
2021041008
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019029494
MISSOURI STATE BOARD OF NURSING
MO
01
—
2021041008
APRN LICENSE
MO
Enumeration date
10/01/2021
Last updated
10/13/2021
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