Provider Demographics
NPI:1003212952
Name:KRUMMEN, ALICIA (APRN WHNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:KRUMMEN
Suffix:
Gender:F
Credentials:APRN WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 BURLINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1513
Mailing Address - Country:US
Mailing Address - Phone:859-363-2060
Mailing Address - Fax:859-647-3594
Practice Address - Street 1:7505 BURLINGTON PIKE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1513
Practice Address - Country:US
Practice Address - Phone:859-363-2060
Practice Address - Fax:859-647-3594
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12405-NP363LW0102X
KY3007422363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health