1578226486 NPI number — DR KRONLAGE OSTEOPATHIC CARE, PLLC

Table of content: MS. KEISA MARIA HEARD LPN (NPI 1659929396)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578226486 NPI number — DR KRONLAGE OSTEOPATHIC CARE, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR KRONLAGE OSTEOPATHIC CARE, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578226486
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
825 MERRIMON AVE STE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28804-2467
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-808-2601
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33 ORANGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28801-2328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-390-1793
Provider Business Practice Location Address Fax Number:
520-306-4937
Provider Enumeration Date:
10/18/2021

Additional Information

Authorized Official

Authorized Official Last Name:
KRONLAGE
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/MEMBER
Authorized Official Telephone Number:
828-808-2601

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 204D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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