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NPI Code Detail

MEDICARE: MRS. SUSAN KRUPP LPN

MEDICARE: MRS. SUSAN KRUPP LPN
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
1164W00000XLicensed Practical NurseLPN.028799.MEDSOH

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 : 1588115190
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN KRUPP LPN
Provider Business Mailing Address
First Line : 1001 PARK AVE
Second Line :
City : FOSTORIA
State : OH
Zip : 44830-1455
Country : US
Telephone Number : 419-436-4110
Fax Number :
Provider Business Practice Location Address
First Line : 1001 PARK AVE
Second Line :
City : FOSTORIA
State : OH
Zip : 44830-1455
Country : US
Telephone Number : 419-436-4110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2016
Last Update Date : 10/18/2016

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Directions to “ MRS. SUSAN KRUPP LPN” Practice Location

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