Provider Demographics
NPI:1427543685
Name:CRONENWETT, MEREDITH (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:CRONENWETT
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3596 NW DEER OAK DR
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-3444
Mailing Address - Country:US
Mailing Address - Phone:954-663-9930
Mailing Address - Fax:
Practice Address - Street 1:3596 NW DEER OAK DR
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-3444
Practice Address - Country:US
Practice Address - Phone:954-663-9930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-28
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009324363LA2200X, 363LG0600X
FL11005561363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health