Provider Demographics
NPI:1760417877
Name:KROM, JANE ANN (CPNP)
Entity Type:Individual
Prefix:MISS
First Name:JANE
Middle Name:ANN
Last Name:KROM
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 DISCOVERY DR
Mailing Address - Street 2:CHESAPEAKE
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3871
Mailing Address - Country:US
Mailing Address - Phone:757-668-2500
Mailing Address - Fax:757-668-2510
Practice Address - Street 1:500 DISCOVERY DR
Practice Address - Street 2:CHESAPEAKE
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3871
Practice Address - Country:US
Practice Address - Phone:757-668-2500
Practice Address - Fax:757-668-2510
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA24102391363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0778849Medicaid
NC7004780Medicaid
VA96630NOtherOPTIMA HEALTH
VA0778849Medicaid