MEDICARE: NICOLE KRUGER

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1912668369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE KRUGER

Provider Business Mailing Address
First Line	:	5142 DURHAM RD W
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-1414
Country	:	US
Telephone Number	:	202-689-9351
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 WISCONSIN AVE NW STE 300
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007-3680
Country	:	US
Telephone Number	:	202-689-9351
Fax Number	:

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

Provider Enumeration Date	:	01/07/2022
Last Update Date	:	12/22/2025

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Directions to “ NICOLE KRUGER ” Practice Location

Language	Start Address	Practice Location

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