Provider Demographics
NPI:1558102368
Name:KROELL, KAITLYN CLAIRE
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:CLAIRE
Last Name:KROELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8945 FARMDALE WAY
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-9218
Mailing Address - Country:US
Mailing Address - Phone:513-716-2936
Mailing Address - Fax:
Practice Address - Street 1:8945 FARMDALE WAY
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-9218
Practice Address - Country:US
Practice Address - Phone:513-716-2936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG