Provider Demographics
NPI:1154530228
Name:KRUEGER, JENNIFER LYNNE (MA, ATC)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:LYNNE
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:MA, ATC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNNE
Other - Last Name:KRUEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5716 S 95TH PLZ APT 8
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3487
Mailing Address - Country:US
Mailing Address - Phone:402-540-7677
Mailing Address - Fax:
Practice Address - Street 1:6001 DODGE STREET HPER 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68182
Practice Address - Country:US
Practice Address - Phone:402-554-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer