Healthcare Provider Details

I. General information

NPI: 1235704545
Provider Name (Legal Business Name): KIMBERLY K KRUHLIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY K HEDGLEN

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 ROCK ST
MARQUETTE MI
49855-4783
US

IV. Provider business mailing address

347 ROCK ST
MARQUETTE MI
49855-4783
US

V. Phone/Fax

Practice location:
  • Phone: 906-227-9176
  • Fax: 906-228-2469
Mailing address:
  • Phone: 906-227-9176
  • Fax: 906-228-2469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801122144
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: