MEDICARE: JANEY MELISSA KRONEBERGER

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1629778923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANEY MELISSA KRONEBERGER

Provider Business Mailing Address
First Line	:	11800 ARBOR LAKES PKWY N UNIT 2413
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-2279
Country	:	US
Telephone Number	:	469-929-3061
Fax Number	:

Provider Business Practice Location Address
First Line	:	11800 ARBOR LAKES PKWY N UNIT 2413
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55369-2279
Country	:	US
Telephone Number	:	469-929-3061
Fax Number	:

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

Provider Enumeration Date	:	03/06/2023
Last Update Date	:	03/06/2023

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