Provider Demographics
NPI:1376700310
Name:KRENITSKY, BRENDA LB (RN)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:LB
Last Name:KRENITSKY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 JORDAN LN
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-5432
Mailing Address - Country:US
Mailing Address - Phone:978-388-5867
Mailing Address - Fax:978-681-9508
Practice Address - Street 1:439 S UNION ST
Practice Address - Street 2:1-110
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-2837
Practice Address - Country:US
Practice Address - Phone:978-682-9222
Practice Address - Fax:978-681-9508
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA169915163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA169915OtherREGISTERED NURSE