Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 12010906A | IN |
N | 1223E0200X | Endodontist | 8101 | KY |
NPI | 1003950064 |
---|---|
Provider Name | Dr. Jennifer I Kron |
First Address | New Albany, IN 47150-0001 |
Second Address | New Albany, IN 47150-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 08/07/2007 |