Individual
LISA PIVOTTO KROENING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
18315 CASCADE DR, STE 170, EDEN PRAIRIE, MN 55347-1180
(952) 831-1944
(952) 278-6947
Mailing address
3955 PARKLAWN AVE, EDINA, MN 55435-5655
(952) 831-1944
(952) 278-6947
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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