Healthcare Provider Details

I. General information

NPI: 1861301053
Provider Name (Legal Business Name): KATHERINE ROSE KROCHKO APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 N OCEAN BLVD
POMPANO BEACH FL
33062-5116
US

IV. Provider business mailing address

405 N OCEAN BLVD APT 1724
POMPANO BEACH FL
33062-5157
US

V. Phone/Fax

Practice location:
  • Phone: 781-985-3155
  • Fax:
Mailing address:
  • Phone: 781-985-3155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11050696
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: