Provider Demographics
NPI:1396939369
Name:KRUCIAK, BRITTANY MICHELLE (HS)
Entity type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:MICHELLE
Last Name:KRUCIAK
Suffix:
Gender:F
Credentials:HS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W BENSON RD
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-3904
Mailing Address - Country:US
Mailing Address - Phone:210-288-0384
Mailing Address - Fax:
Practice Address - Street 1:320 W BENSON RD
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-3904
Practice Address - Country:US
Practice Address - Phone:210-288-0384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other