Provider Demographics
NPI:1528618311
Name:TAYLOR KREGEL, EKUA G (RN, CNM, MA)
Entity type:Individual
Prefix:
First Name:EKUA
Middle Name:G
Last Name:TAYLOR KREGEL
Suffix:
Gender:F
Credentials:RN, CNM, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55041-1251
Mailing Address - Country:US
Mailing Address - Phone:651-724-2400
Mailing Address - Fax:651-600-3142
Practice Address - Street 1:1315 N 7TH ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:MN
Practice Address - Zip Code:55041-1251
Practice Address - Country:US
Practice Address - Phone:651-724-2400
Practice Address - Fax:651-600-3142
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1080883163WH0200X, 163WX0002X, 163WX0003X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient