Provider Demographics
NPI:1841594264
Name:CRONAN, JOHANNA ELIZABETH (MSN, FNP-BC, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:JOHANNA
Middle Name:ELIZABETH
Last Name:CRONAN
Suffix:
Gender:F
Credentials:MSN, FNP-BC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7340 SW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-4102
Mailing Address - Country:US
Mailing Address - Phone:352-207-5729
Mailing Address - Fax:
Practice Address - Street 1:114 SE 20TH AVE
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-7547
Practice Address - Country:US
Practice Address - Phone:954-933-0597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP #9247443363LF0000X
FL9247443163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant