Provider Demographics
NPI:1043253735
Name:KRENZKE, KAREN C (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:C
Last Name:KRENZKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:107 FLYNN DR 600
Mailing Address - Street 2:
Mailing Address - City:MILBANK
Mailing Address - State:SD
Mailing Address - Zip Code:57252-1557
Mailing Address - Country:US
Mailing Address - Phone:605-432-6621
Mailing Address - Fax:605-432-5669
Practice Address - Street 1:WAPITI MEDICAL GROUP
Practice Address - Street 2:7012 MAPLE CREEK
Practice Address - City:LAKE NEBAGAMON
Practice Address - State:WI
Practice Address - Zip Code:54849
Practice Address - Country:US
Practice Address - Phone:715-374-3602
Practice Address - Fax:715-374-2677
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI30434-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31555400Medicaid
WI31555400Medicaid