Provider Demographics
NPI:1790861771
Name:GRONCKI-MENINGER, PATRICIA FINK (MS, CPNP, CFNP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:FINK
Last Name:GRONCKI-MENINGER
Suffix:
Gender:F
Credentials:MS, CPNP, CFNP
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:FINK
Other - Last Name:GRONCKI-REICHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CPNP, CFNP
Mailing Address - Street 1:2822 ONYX RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5639
Mailing Address - Country:US
Mailing Address - Phone:410-661-3677
Mailing Address - Fax:410-661-3684
Practice Address - Street 1:9150 FRANKLIN SQUARE DR
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-3903
Practice Address - Country:US
Practice Address - Phone:410-887-6452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0023100-06363LP0200X
MD343880-22363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics