Healthcare Provider Details

I. General information

NPI: 1144703968
Provider Name (Legal Business Name): TARYN DANEA KRIGBAUM APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2018
Last Update Date: 07/18/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 3310,0
APO AE
09180-3100
US

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 3310,0
APO AE
09180
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-4027
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number0203988
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPN.0996500-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: