Provider Demographics
NPI:1265470785
Name:KREUL, SUE F (ANP)
Entity Type:Individual
Prefix:MS
First Name:SUE
Middle Name:F
Last Name:KREUL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5245 NW ROCKY WAY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-1323
Mailing Address - Country:US
Mailing Address - Phone:541-574-1009
Mailing Address - Fax:
Practice Address - Street 1:5245 NW ROCKY WAY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-1323
Practice Address - Country:US
Practice Address - Phone:541-574-1009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR075034905RN/N3363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORS57476Medicare UPIN