Provider Demographics
NPI:1558478099
Name:KRUKOWSKI, SHARON A (APNP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:A
Last Name:KRUKOWSKI
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:A
Other - Last Name:MERTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5818 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2247
Mailing Address - Country:US
Mailing Address - Phone:414-449-2114
Mailing Address - Fax:
Practice Address - Street 1:5818 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2247
Practice Address - Country:US
Practice Address - Phone:414-449-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101598-030363L00000X
WI1188-033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner