Individual provider Active NPI

Jillian Kroneberger, RN

  • Emergency Registered Nurse
  • Fort Defiance, AZ
National Provider Identifier
1114636719
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
RN215785 Issued in AZ
Practice address
N12 & N7
Fort Defiance, AZ 86504
Phone
(928) 729-8000
NPI assigned
Nov 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN215785 AZ Primary

Addresses

Primary practice location

N12 & N7
Fort Defiance, AZ 86504

Mailing address

1355 E Cliffrose LN
Flagstaff, AZ 86001-7850
Phone (928) 606-7396

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL jillian.kroneberger@fdihb.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN215785AZMDEmergency Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1114636719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 E CLIFFROSE LN",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860017850",
            "telephone_number": "928-606-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N12 & N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRONEBERGER",
        "first_name": "JILLIAN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "AZ",
            "license": "RN215785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jillian.kroneberger@fdihb.org",
            "affiliation": "N",
            "address_1": "N12 & N7",
            "city": "Fort Defiance",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "86504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Defiance, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.