Jennifer D Krejcarek
Individual provider Active NPI Nurse Practitioner · Kitty Hawk, NC
NPI 1619543741 · NPPES record last updated May 30, 2021
Key facts
- NPI
- 1619543741
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 5014485 (NC)
- Practice address
- 5116 N Croatan Hwy
Kitty Hawk, NC 27949-3988 - Phone
- (252) 335-2293
- NPI assigned
- May 30, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210929002054 | NC | Practitioner - Nurse Practitioner | 0143627422 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Coastal Plastic Surgery, PC | Current |
Accepting new patients |
Locations
1141 N Road St
Ste K
Elizabeth Cty, NC 27909
Phone (252) 331-7600
5116 N Croatan Hwy
Kitty Hawk, NC 27949
Phone (252) 255-5234
Interoperability endpoints
- https://api.platform.athenahealth.com/2255/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5014485 | NC | Yes |
Addresses
Primary practice location
5116 N Croatan Hwy
Kitty Hawk, NC 27949-3988
Mailing address
903 Suffolk St
Kill Devil Hills, NC 27948-8211
Phone (757) 404-7444
Other practice location 1
1141 N Road St Ste K
Elizabeth City, NC 27909-3354
Phone (252) 335-2293
Other providers in Kitty Hawk, NC
- Amy C Johnson
- Ken J Tompkins MD PC
- Ken J Tompkins MD PC
- Celeste Kendrick
- King Podiatry and Associates PLLC
- Deborah B Lees-Shepard
- Katherine Eileen Lindsay Biscaha
- Donald E Lovis
- Donna M Lowcher
- Jennifer E Lunceford
All providers in Kitty Hawk, NC · Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.