Provider Demographics
NPI:1861022097
Name:KRAKLOW, DENISE (RN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:KRAKLOW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:RENEE
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8761 W WHISPERING OAKS CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8542
Mailing Address - Country:US
Mailing Address - Phone:414-975-2342
Mailing Address - Fax:
Practice Address - Street 1:8761 W WHISPERING OAKS CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8542
Practice Address - Country:US
Practice Address - Phone:414-975-2342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI157917163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse