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NPI Code Detail

MEDICARE: MRS. LUCINDA RENEE KROLL DNP

MEDICARE: MRS. LUCINDA RENEE KROLL DNP
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
1363LG0600XGerontology Nurse Practitioner4704310177MI

General Provider Information

NPI Number : 1588320543
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LUCINDA RENEE KROLL DNP
Provider Business Mailing Address
First Line : 47700 SUGARBUSH RD
Second Line :
City : CHESTERFIELD
State : MI
Zip : 48047-2201
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 303 E KEARSLEY ST
Second Line :
City : FLINT
State : MI
Zip : 48502-1950
Country : US
Telephone Number : 586-206-9792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2021
Last Update Date : 11/19/2025

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