Provider Demographics
NPI:1417682295
Name:KRENZ, COREY JACOB (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:COREY
Middle Name:JACOB
Last Name:KRENZ
Suffix:
Gender:M
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 1:105 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-1992
Mailing Address - Country:US
Mailing Address - Phone:816-244-9814
Mailing Address - Fax:
Practice Address - Street 1:901 HEARTLAND RD.
Practice Address - Street 2:# 1800, PLAZA 2
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-6202
Practice Address - Country:US
Practice Address - Phone:816-232-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022027784363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily