Provider Demographics
NPI:1427860675
Name:KROENING, CARLY MAE
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:MAE
Last Name:KROENING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:
Other - Last Name:STRANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10765 BOSTON ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80640-8969
Mailing Address - Country:US
Mailing Address - Phone:970-426-9410
Mailing Address - Fax:
Practice Address - Street 1:1805 COLORADO AVE
Practice Address - Street 2:RM W107, 324 UCB
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80309
Practice Address - Country:US
Practice Address - Phone:303-735-2304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1666467163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse