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NPI Code Detail

MEDICARE: MATTHEW KROHN FNP-C

MEDICARE: MATTHEW KROHN FNP-C
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
1363LF0000XFamily Nurse Practitioner71017927AIN
2363LF0000XFamily Nurse PractitionerNP004914GA
3363LF0000XFamily Nurse PractitionerC-APN.0103710-C-NPCO
4363LF0000XFamily Nurse PractitionerA189493IA
5363LF0000XFamily Nurse PractitionerAPRN.CNP.023063OH

General Provider Information

NPI Number : 1629554514
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW KROHN FNP-C
Provider Business Mailing Address
First Line : PO BOX 211699
Second Line :
City : EAGAN
State : MN
Zip : 55121-3699
Country : US
Telephone Number : 866-849-0692
Fax Number : 888-973-8821
Provider Business Practice Location Address
First Line : 3700 PARK EAST DR STE 450
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-4318
Country : US
Telephone Number : 866-849-0692
Fax Number : 888-973-8821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2018
Last Update Date : 04/14/2026

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