Provider Demographics
NPI:1487694634
Name:KRUEGER, PAMELA ANN (RN)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 HILLSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-8359
Mailing Address - Country:US
Mailing Address - Phone:608-845-3687
Mailing Address - Fax:
Practice Address - Street 1:410 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:ARENA
Practice Address - State:WI
Practice Address - Zip Code:53503-9685
Practice Address - Country:US
Practice Address - Phone:608-712-0773
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI93028-030163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health