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Individual
LISA PIVOTTO KROENING
Active
Individual
LISA PIVOTTO KROENING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R111593
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1200184
MEDICA
MN
01
—
9G994KR
BC/BS
MN
01
—
FP9021013319
PREFERRED ONE
MN
Enumeration date
10/26/2006
Last updated
07/08/2007
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