Provider Demographics
NPI:1770920779
Name:KRUEGER, ALYSIA M (APNP)
Entity type:Individual
Prefix:
First Name:ALYSIA
Middle Name:M
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:ALYSIA
Other - Middle Name:M
Other - Last Name:MOEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3030 LAURA LN STE 130
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-1872
Mailing Address - Country:US
Mailing Address - Phone:888-688-4746
Mailing Address - Fax:608-960-7789
Practice Address - Street 1:3030 LAURA LN STE 130
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-1872
Practice Address - Country:US
Practice Address - Phone:888-688-4746
Practice Address - Fax:608-960-7789
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14368-33363LF0000X
WI170613-030163W00000X
AZAP5004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse