Provider Demographics
NPI:1033188321
Name:KROEGER, LINDA (APRN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:KROEGER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 S 70TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2960
Mailing Address - Country:US
Mailing Address - Phone:402-423-4200
Mailing Address - Fax:402-423-4201
Practice Address - Street 1:2611 S 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2960
Practice Address - Country:US
Practice Address - Phone:402-423-4200
Practice Address - Fax:402-423-4201
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-44576363LF0000X, 363LG0600X
NE112386207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSR94986Medicare UPIN