Provider Demographics
NPI:1942988233
Name:KRIENER, KENDRA MICHAELA
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:MICHAELA
Last Name:KRIENER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KENDRA
Other - Middle Name:MICHAELA
Other - Last Name:WISINSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:3263 PROFFIT RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-5639
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3263 PROFFIT RD STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-5639
Practice Address - Country:US
Practice Address - Phone:434-654-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024187494363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily