Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 0024180681 | VA |
N | 363L00000X | Nurse Practitioner | 2017005142 | MO |
N | 363LA2100X | Nurse Practitioner - Acute Care | 0024180681 | VA |
N | 363LA2100X | Nurse Practitioner - Acute Care | 2017005142 | MO |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 108118 | WV |
NPI | 1558899377 |
---|---|
Provider Name | Maki K Cronin |
First Address | Lafayette, LA 70508-3870 |
Second Address | Saint Charles, MO 63301-2844 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2017 |
Last Update Date | 06/12/2021 |