Provider Demographics
NPI:1063469138
Name:KRUEGER, IVETTE MERCEDES (RN)
Entity Type:Individual
Prefix:MRS
First Name:IVETTE
Middle Name:MERCEDES
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5185 SE 39TH LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-0637
Mailing Address - Country:US
Mailing Address - Phone:352-694-6637
Mailing Address - Fax:
Practice Address - Street 1:1801 SE 32ND AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5532
Practice Address - Country:US
Practice Address - Phone:352-629-0137
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3325492163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool