Provider Demographics
NPI:1265707889
Name:CRONIN, MARY A (CRNP)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:A
Last Name:CRONIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1021 SNOWSHILL CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5649
Mailing Address - Country:US
Mailing Address - Phone:205-266-7650
Mailing Address - Fax:
Practice Address - Street 1:4704 CAHABA RIVER RD
Practice Address - Street 2:STE 101-D
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-2344
Practice Address - Country:US
Practice Address - Phone:205-739-2266
Practice Address - Fax:205-739-2335
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-14
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1119324363LX0106X
AL1-119324364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health