Provider Demographics
NPI:1053636696
Name:KRUEGER, KAREN J (LPN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2857 HAPPY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-9432
Mailing Address - Country:US
Mailing Address - Phone:608-834-0388
Mailing Address - Fax:
Practice Address - Street 1:2857 HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-9432
Practice Address - Country:US
Practice Address - Phone:608-834-0388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI27198031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse