Individual provider Active NPI

Elisa Mercedes Cronan, LPN

  • Licensed Practical Nurse
  • Wellington, FL
National Provider Identifier
1184161648
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN708281 Issued in FL
Practice address
11924 Forest Hill Blvd
10A-243
Wellington, FL 33414-6256
Phone
(561) 693-5143
NPI assigned
Jan 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN708281 FL Primary

Addresses

Primary practice location

11924 Forest Hill Blvd
10A-243
Wellington, FL 33414-6256

Mailing address

101 Galiano St
Royal Palm Beach, FL 33411-1205

Other identifiers 1

IdentifierTypeStateIssuer
PN708281OtherFLLPN LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PN708281FLMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1184161648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GALIANO ST",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334111205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11924 FOREST HILL BLVD",
            "address_2": "10A-243",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146256",
            "telephone_number": "561-693-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONAN",
        "first_name": "ELISA",
        "middle_name": "MERCEDES",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN708281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPN LICENSE",
            "identifier": "PN708281",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.