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General NPI Number Information
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NPI Number | 1285131375
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Entity Type | Individual
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Provider Name | BRIAN WILLIAM CRONSTROM APRN-C
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Gender | Male
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Dates
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Enumeration Date | 04/06/2018
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 300 E 12TH ST
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City | COZAD
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State | NE
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Zip | 69130-1532
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Country | US
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Telephone | 308-784-2261
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Fax | 308-784-4961
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Provider Business Mailing Address
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Address Line | PO BOX 108
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City | COZAD
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State | NE
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Zip | 69130-0108
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Country | US
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Telephone | 308-784-2261
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Fax | 308-784-4691
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 112437
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 112437
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License Number State | NE
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