Provider Demographics
NPI:1083055370
Name:KRULL, DONNA M
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:M
Last Name:KRULL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13281 CTY. HWY. 42
Mailing Address - Street 2:
Mailing Address - City:PARKERS PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56361
Mailing Address - Country:US
Mailing Address - Phone:320-808-3853
Mailing Address - Fax:218-338-5118
Practice Address - Street 1:13281 CTY. HWY. 42
Practice Address - Street 2:
Practice Address - City:PARKERS PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:56361
Practice Address - Country:US
Practice Address - Phone:320-808-3853
Practice Address - Fax:218-338-5118
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA106625200OtherUMPI