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General NPI Number Information
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NPI Number | 1184656399
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Entity Type | Individual
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Provider Name | KATHLEEN LLOYD CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 06/27/2020
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Provider Practice Location Address
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Address Line | 3000 ESSEX RD
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City | TINTON FALLS
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State | NJ
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Zip | 07753-2631
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Country | US
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Telephone | 732-643-2070
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Fax | 732-643-2015
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Provider Business Mailing Address
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Address Line | 9900 BREN RD E
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City | MINNETONKA
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State | MN
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Zip | 55343-9664
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NN05956100
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License Number State | NJ
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