Rhonda Parrella Krossner
Individual provider Active NPI Psychologist · Duluth, MN
NPI 1851322952 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1851322952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- LP2472 (MN)
- Practice address
- 400 E 3Rd St
Duluth, MN 55805-1951 - Phone
- (218) 786-8364
- NPI assigned
- Jul 6, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP2472 | MN | Yes |
Addresses
Primary practice location
400 E 3Rd St
Duluth, MN 55805-1951
Mailing address
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39033300 | Medicaid | WI |
NPI Registry JSON
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851322952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-8364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-8364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROSSNER",
"first_name": "RHONDA",
"middle_name": "PARRELLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP2472",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39033300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.