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NPI Code Detail

MEDICARE: MRS. JANET DIANE KRUEGER R.N.

MEDICARE: MRS. JANET DIANE KRUEGER R.N.
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
1163WP0809XAdult Psychiatric/Mental Health Registered Nurse52145-30WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
152145-30OTHERWIREGISTERED NURSE

General Provider Information

NPI Number : 1740325406
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANET DIANE KRUEGER R.N.
Provider Business Mailing Address
First Line : 4929 W FOND DU LAC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53216-2324
Country : US
Telephone Number : 414-871-6122
Fax Number : 414-871-2552
Provider Business Practice Location Address
First Line : 4929 W FOND DU LAC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53216-2324
Country : US
Telephone Number : 414-871-6122
Fax Number : 414-871-2552
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/08/2007

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