Provider Demographics
NPI:1861828303
Name:KRUEGER, TAMORA LYNN (WHNP-C, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:TAMORA
Middle Name:LYNN
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:WHNP-C, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12602 TOEPPERWEIN RD STE 208
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3271
Mailing Address - Country:US
Mailing Address - Phone:210-878-0090
Mailing Address - Fax:201-878-0037
Practice Address - Street 1:12602 TOEPPERWEIN RD STE 208
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3271
Practice Address - Country:US
Practice Address - Phone:210-878-0090
Practice Address - Fax:210-878-0037
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123946363LW0102X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health