Provider Demographics
NPI:1558483719
Name:KRUEGER, LIATTE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:LIATTE
Middle Name:
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 41ST ST NW
Mailing Address - Street 2:APT B303
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-4247
Mailing Address - Country:US
Mailing Address - Phone:908-499-5998
Mailing Address - Fax:
Practice Address - Street 1:2110 E CENTER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-4754
Practice Address - Country:US
Practice Address - Phone:507-287-0674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRI31305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist