MEDICARE: ALLEYNAH MARIE KREGLOW RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	390200000X	Student in an Organized Health Care Education/Training Program	RN.479831	OH

General Provider Information

NPI Number	:	1154166197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLEYNAH MARIE KREGLOW RN

Provider Business Mailing Address
First Line	:	6531 MEADOWCROFT LN
Second Line	:
City	:	MAUMEE
State	:	OH
Zip	:	43537-1128
Country	:	US
Telephone Number	:	567-201-8257
Fax Number	:

Provider Business Practice Location Address
First Line	:	6531 MEADOWCROFT LN
Second Line	:
City	:	MAUMEE
State	:	OH
Zip	:	43537-1128
Country	:	US
Telephone Number	:	567-342-2299
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2024
Last Update Date	:	07/01/2024

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