Provider Demographics
NPI:1609556836
Name:KRECHKO, SVETLANA V (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SVETLANA
Middle Name:V
Last Name:KRECHKO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9940 SW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-0903
Mailing Address - Country:US
Mailing Address - Phone:845-260-3588
Mailing Address - Fax:
Practice Address - Street 1:9940 SW 12TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-0903
Practice Address - Country:US
Practice Address - Phone:845-260-3588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027062363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty