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General NPI Number Information
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NPI Number | 1093353773
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Entity Type | Individual
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Provider Name | ROBERT P KRUPP NURSE PRACTITIONER
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Gender | Male
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 3520 FOREST RD FL 2
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City | LANSING
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State | MI
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Zip | 48910-3720
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Country | US
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Telephone | 517-975-9500
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Fax | 517-975-9520
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Provider Business Mailing Address
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Address Line | 24 FRANK LLOYD WRIGHT DR LBBY J2000
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City | ANN ARBOR
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State | MI
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Zip | 48105-9484
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Country | US
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Telephone | 734-747-6766
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Fax | 734-222-3100
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704297058
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License Number State | MI
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