Provider Demographics
NPI:1376981381
Name:KRUG, KAREN ANN (MA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:KRUG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 898
Mailing Address - Street 2:
Mailing Address - City:HEBER SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72543
Mailing Address - Country:US
Mailing Address - Phone:501-362-4279
Mailing Address - Fax:
Practice Address - Street 1:110 CASE FORD RD. SUITE A
Practice Address - Street 2:
Practice Address - City:HEBER SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72543
Practice Address - Country:US
Practice Address - Phone:501-365-3972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR405235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist