Most Relevant Information
Provider Data
| NPI Number: | 1003461856 |
| Provider Name: | STACIE LYNN KROM LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 277782-1 |
Most Important Dates
| Enumeration Date: | 08/08/2019 |
| Last Updated: | 08/08/2019 |
Provider Practice Location
3 CHARLES ST
ELLENVILLE
NY
124282303
Practice Location Phone/Fax
| Phone: | 3219464541 |
| Fax: |
Provider Mailing Location
7062 ROUTE 209
KERHONKSON
NY
124462957
Provider Mailing Phone/Fax
| Phone: | 3219464541 |
| Fax: |