Healthcare Provider Details

I. General information

NPI: 1669306353
Provider Name (Legal Business Name): HANNAH MICHELLE KRUG PNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11949 Q ST
OMAHA NE
68137-3503
US

IV. Provider business mailing address

14507 SARATOGA ST
OMAHA NE
68116-6631
US

V. Phone/Fax

Practice location:
  • Phone: 402-595-1326
  • Fax:
Mailing address:
  • Phone: 720-883-4556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number116748
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: