Provider Demographics
NPI:1316392954
Name:KRENTZEL, JUDY (FNP-C)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:KRENTZEL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2752 N SARAMANO LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-5264
Mailing Address - Country:US
Mailing Address - Phone:520-400-5155
Mailing Address - Fax:
Practice Address - Street 1:2752 N SARAMANO LN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-5264
Practice Address - Country:US
Practice Address - Phone:520-400-5155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN080456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily