Healthcare Provider Details

I. General information

NPI: 1255663100
Provider Name (Legal Business Name): KRISTY A KRUGER OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTY A SCHERER OT

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 WILLOW ST
VINCENNES IN
47591-5355
US

IV. Provider business mailing address

7300 E INDIANA ST SUITE 102
EVANSVILLE IN
47715-2794
US

V. Phone/Fax

Practice location:
  • Phone: 812-882-1141
  • Fax: 812-255-0045
Mailing address:
  • Phone: 812-476-0409
  • Fax: 812-476-1016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31004755A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: