Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | POD-000716 | AZ |
Y | 222Z00000X | Podiatrist | POD-000716 | AZ |
N | 213EP1101X | Primary Podiatric Medicine | TRAINING CERTIFICATE | OH |
NPI | 1023282100 |
---|---|
Provider Name | Dr. Janna Lynn Kroleski |
First Address | Glendale, AZ 85308-6500 |
Second Address | Glendale, AZ 85308-6500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2008 |
Last Update Date | 05/05/2020 |