Provider Demographics
NPI:1538539994
Name:KRTALIC, RENEA (FNP-BC)
Entity type:Individual
Prefix:
First Name:RENEA
Middle Name:
Last Name:KRTALIC
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 SW 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1704
Mailing Address - Country:US
Mailing Address - Phone:806-547-0330
Mailing Address - Fax:806-547-0331
Practice Address - Street 1:7120 SW 9TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1704
Practice Address - Country:US
Practice Address - Phone:806-547-0330
Practice Address - Fax:806-547-0331
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129163363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily