Provider Demographics
NPI:1518485333
Name:KRUPPENBACH, KATHERINE HALL (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:HALL
Last Name:KRUPPENBACH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:MARIE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 KIMEL FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6074
Mailing Address - Country:US
Mailing Address - Phone:336-716-1331
Mailing Address - Fax:336-716-3202
Practice Address - Street 1:223 W WARD ST STE B
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203
Practice Address - Country:US
Practice Address - Phone:336-702-1731
Practice Address - Fax:336-702-3014
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207610363L00000X, 363LF0000X
NC5009791363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily