Individual
KIMBERLY CRONSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7019 HARPS MILL RD STE 200, RALEIGH, NC 27615-3248
(919) 850-1300
(919) 850-0012
Mailing address
7019 HARPS MILL RD STE 200, RALEIGH, NC 27615-3248
(919) 850-1300
(919) 850-0012
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0010-07178
NC
363AM0700X
Medical Physician Assistant
Primary
0010-07178
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-07178
MEDICAL LICENSE
NC
Enumeration date
07/17/2017
Last updated
03/07/2023
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