Provider Demographics
NPI:1508213513
Name:CRONIN, JUDITH LYNN (NP-C)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:LYNN
Last Name:CRONIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 COLUMBIA AVE E STE 11A
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5462
Mailing Address - Country:US
Mailing Address - Phone:269-245-5430
Mailing Address - Fax:
Practice Address - Street 1:485 COLUMBIA AVE E STE 11A
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5462
Practice Address - Country:US
Practice Address - Phone:269-245-5430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704208201363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily