Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1134242274 |
---|---|
Provider Name | Lindsey Ann Kroll |
First Address | Avoca, WI 53506-9327 |
Second Address | Avoca, WI 53506-9327 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 08/07/2007 |