Individual
JENNIFER L CRONENWETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1531 E 32ND ST STE 6, JOPLIN, MO 64804-9810
(417) 627-9699
(417) 627-9602
Mailing address
5404 BUTTERFIELD PL, LOMA LINDA, MO 64804-8870
(417) 439-7448
(417) 782-7831
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2004000338
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200020780A
—
OK
05
—
200252340A
—
KS
05
—
919028001
—
MO
01
—
P00112983
RR MEDICARE
—
Enumeration date
05/26/2006
Last updated
08/28/2008
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