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General NPI Number Information
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NPI Number | 1073934048
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Entity Type | Organization
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Legal Business Name | LYNNE M KREBS CRNA SC
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Dates
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Enumeration Date | 12/18/2013
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | W178N9912 RIVERCREST DR STE 102
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City | GERMANTOWN
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State | WI
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Zip | 53022-4645
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Country | US
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Telephone | 262-672-9000
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Fax | 262-290-2726
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Provider Business Mailing Address
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Address Line | PO BOX 8031
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City | APPLETON
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State | WI
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Zip | 54912-8031
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Country | US
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Telephone | 866-313-0337
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Fax | 920-739-0124
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Authorized Official
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Title or Position | OWNER
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Name | LYNNE M KREBS
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Credential | CRNA
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Telephone | 262-335-0533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 42233
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License Number State | WI
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