Provider Demographics
NPI:1033152061
Name:KRIEGE, JOANNE M (MD)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:M
Last Name:KRIEGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 TUTTLE ST
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-1501
Mailing Address - Country:US
Mailing Address - Phone:608-355-2033
Mailing Address - Fax:608-355-6820
Practice Address - Street 1:1626 TUTTLE ST
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-1501
Practice Address - Country:US
Practice Address - Phone:608-355-2033
Practice Address - Fax:608-355-6820
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI30435-020207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1033152061Medicaid
WI4638OtherDEAN HEALTH INSURANCE
WI31994900Medicaid
WI4638OtherDEAN HEALTH INSURANCE
WI005057085Medicare PIN
WI660002608Medicare PIN