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Individual

DR. JACQUELINE ANNE KROHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD MPH

Contact information

Practice address
3917 WEST RD, SUITE 136, LOS ALAMOS, NM 87544-2275
(505) 662-9620
(505) 662-0024
Mailing address
3917 WEST RD, SUITE 136, LOS ALAMOS, NM 87544-2275
(505) 662-9620
(505) 662-0024

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
79195
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
11783
NM
Enumeration date
10/27/2005
Last updated
08/16/2007
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