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General NPI Number Information
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NPI Number | 1275123903
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Entity Type | Individual
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Provider Name | KRISTI JO KRUEGER FNP
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Gender | Female
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 226 GARDEN BROOK DR
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City | MADISON
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State | AL
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Zip | 35758-7886
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Country | US
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Telephone | 719-351-9175
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Fax |
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Provider Business Mailing Address
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Address Line | 226 GARDEN BROOK DR
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City | MADISON
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State | AL
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Zip | 35758-7886
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Country | US
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Telephone | 719-351-9175
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1-163577
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-163577
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 1-163577
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 1-163577
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1-163577
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License Number State | AL
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Taxonomy #6
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | 1-163577
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License Number State | AL
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