Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 20169 | MN |
Y | 2086X0206X | Surgical Oncologist | A116220 | CA |
NPI | 1265624209 |
---|---|
Provider Name | Dr. Shauna Werth Kronfuss |
First Address | Bozeman, MT 59715-6902 |
Second Address | Bozeman, MT 59715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2007 |
Last Update Date | 29/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20169 | RESIDENCY PERMIT # (01) | MN |