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NPI Code Detail

MEDICARE: DR. ERIN LEE KRUEGER AU.D.

MEDICARE: DR. ERIN LEE KRUEGER AU.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist408156WI
2237600000XAudiologist-Hearing Aid Fitter408156WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427054543
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIN LEE KRUEGER AU.D.
Provider Business Mailing Address
First Line : 130 2ND ST
Second Line : SUITE 198
City : NEENAH
State : WI
Zip : 54956-2883
Country : US
Telephone Number : 920-729-2085
Fax Number : 920-303-4148
Provider Business Practice Location Address
First Line : 855 N WESTHAVEN DR
Second Line : STE 200
City : OSHKOSH
State : WI
Zip : 54904-7668
Country : US
Telephone Number : 920-303-4130
Fax Number : 920-303-4148
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 12/12/2007

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