Provider Demographics
NPI:1437317609
Name:KRAJEWSKI, THERESA MAE (RN)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:MAE
Last Name:KRAJEWSKI
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 1:1107 BASS BLVD
Mailing Address - Street 2:
Mailing Address - City:PROCTOR
Mailing Address - State:MN
Mailing Address - Zip Code:55810-2627
Mailing Address - Country:US
Mailing Address - Phone:218-624-3830
Mailing Address - Fax:218-624-3830
Practice Address - Street 1:1107 BASS BLVD
Practice Address - Street 2:
Practice Address - City:PROCTOR
Practice Address - State:MN
Practice Address - Zip Code:55810-2627
Practice Address - Country:US
Practice Address - Phone:218-624-3830
Practice Address - Fax:218-624-3830
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR084464-8163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health