Provider Demographics
NPI:1356714406
Name:KRENDELSHCHIKOVA, ELENA (AGNP-C)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:KRENDELSHCHIKOVA
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ROSALIND REDFERN GROVER PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5856
Mailing Address - Country:US
Mailing Address - Phone:432-221-3600
Mailing Address - Fax:432-221-5170
Practice Address - Street 1:400 ROSALIND REDFERN GROVER PKWY STE 240
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5856
Practice Address - Country:US
Practice Address - Phone:432-221-3600
Practice Address - Fax:432-221-5170
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129565363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily