Provider Demographics
NPI:1316979115
Name:RENFRO, CHRISTINE KERR (APRN, C-FNP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:KERR
Last Name:RENFRO
Suffix:
Gender:F
Credentials:APRN, C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5326 W 11000 N
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-9544
Mailing Address - Country:US
Mailing Address - Phone:801-763-9786
Mailing Address - Fax:
Practice Address - Street 1:5326 W 11000 N
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:UT
Practice Address - Zip Code:84003-9544
Practice Address - Country:US
Practice Address - Phone:801-763-9786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT209109-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT209109-4405OtherSTATE LICENSE