Provider Demographics
NPI:1154832509
Name:KREINBROOK, ERIC WAYNE (CRNP)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:WAYNE
Last Name:KREINBROOK
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5811
Mailing Address - Country:US
Mailing Address - Phone:724-689-4676
Mailing Address - Fax:
Practice Address - Street 1:300 CAMEO LN
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9230
Practice Address - Country:US
Practice Address - Phone:724-834-1326
Practice Address - Fax:724-834-6685
Is Sole Proprietor?:No
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017669363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily