MEDICARE: MRS. ELIZABETH YOUGENE CRONIER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1-084308	AL
2	363LA2200X	Adult Health Nurse Practitioner	1-084308	AL
3	363LG0600X	Gerontology Nurse Practitioner	1-084308	AL
4	363LP2300X	Primary Care Nurse Practitioner	1-084308	AL

General Provider Information

NPI Number	:	1154709699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH YOUGENE CRONIER NP

Provider Business Mailing Address
First Line	:	105 ARROWHEAD DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-4103
Country	:	US
Telephone Number	:	334-391-1233
Fax Number	:

Provider Business Practice Location Address
First Line	:	4135 ATLANTA HWY
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36109-3022
Country	:	US
Telephone Number	:	334-271-4503
Fax Number	:	334-356-9926

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2015
Last Update Date	:	05/10/2016

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