Provider Demographics
NPI:1306292685
Name:KRUEGER - THOR, VIRGINIA MARGARET (APNP)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:MARGARET
Last Name:KRUEGER - THOR
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2266 N PROSPECT AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-6319
Mailing Address - Country:US
Mailing Address - Phone:414-220-9990
Mailing Address - Fax:414-221-0001
Practice Address - Street 1:2266 N PROSPECT AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-6319
Practice Address - Country:US
Practice Address - Phone:414-220-9990
Practice Address - Fax:414-221-0001
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI408-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner