Individual
CAROLYN LOUISE KRENKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5261 CARROLLTON PIKE, SUITE B, WOODLAWN, VA 24381-3030
(276) 238-8876
(276) 238-8886
Mailing address
10900 NUCKOLS RD 110, GLEN ALLEN, VA 23060-9246
(804) 396-6412
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024171506
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295700698
—
VA
01
—
261083931
TAX ID
—
01
—
C10361
GROUP ORGANIZATION PTAN
—
01
—
DN2980
GROUP PTAN
—
01
—
Q52983
PTAN
—
Enumeration date
02/20/2006
Last updated
12/22/2015
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