Provider Demographics
NPI:1124773171
Name:KROM, MEGAN MARIE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:MARIE
Last Name:KROM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
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Mailing Address - Street 1:1411 W BELLA DRIVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-5250
Mailing Address - Country:US
Mailing Address - Phone:765-651-6637
Mailing Address - Fax:765-651-6639
Practice Address - Street 1:1411 W BELLA DRIVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-5250
Practice Address - Country:US
Practice Address - Phone:765-651-6637
Practice Address - Fax:765-651-6639
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28189029A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner