Healthcare Provider Details

I. General information

NPI: 1689896482
Provider Name (Legal Business Name): PATRICIA SHEEHAN KRONCKE RN,CNS,APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E 2ND ST
DEFIANCE OH
43512-2440
US

IV. Provider business mailing address

1400 E 2ND ST
DEFIANCE OH
43512-2440
US

V. Phone/Fax

Practice location:
  • Phone: 419-783-1414
  • Fax: 419-783-3387
Mailing address:
  • Phone: 419-783-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN-145460
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberNS-03213
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: