Provider Demographics
NPI:1588820633
Name:KRUGER, DOYLE DEAN (NP)
Entity Type:Individual
Prefix:
First Name:DOYLE
Middle Name:DEAN
Last Name:KRUGER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SIOUX VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:IA
Mailing Address - Zip Code:51012-1205
Mailing Address - Country:US
Mailing Address - Phone:712-225-6265
Mailing Address - Fax:712-225-6800
Practice Address - Street 1:300 SIOUX VALLEY DR
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:IA
Practice Address - Zip Code:51012-1205
Practice Address - Country:US
Practice Address - Phone:712-225-6265
Practice Address - Fax:712-225-6800
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA096463363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily