Healthcare Provider Details

I. General information

NPI: 1912668369
Provider Name (Legal Business Name): NICOLE KRUGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 WISCONSIN AVE NW STE 300
WASHINGTON DC
20007-3680
US

IV. Provider business mailing address

1010 WISCONSIN AVE NW STE 300
WASHINGTON DC
20007-3680
US

V. Phone/Fax

Practice location:
  • Phone: 202-689-9351
  • Fax:
Mailing address:
  • Phone: 202-689-9351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: