Individual
MARY MILLER KROHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10150 W NATIONAL AVE, MILWAUKEE, WI 53227-2145
(414) 431-3458
Mailing address
732 PENNSYLVANIA AVE, UNIVERSITY CITY, MO 63130-3149
(314) 703-1199
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2004019629
MO
163W00000X
Registered Nurse
852028
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2004019629
MISSOURI STATE BOARD OF NURSING
MO
01
—
852028
CALIFORNIA BOARD OF REGISTERED NURSING
CA
Enumeration date
09/22/2016
Last updated
09/22/2016
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