Provider Demographics
NPI:1588335012
Name:KRUEGER, LAUREL R (CRNA)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:R
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9941 JACARANDA AVE
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-9190
Mailing Address - Country:US
Mailing Address - Phone:352-363-0072
Mailing Address - Fax:
Practice Address - Street 1:671 WINYAH DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1226
Practice Address - Country:US
Practice Address - Phone:407-303-7747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9425878163WC0200X
FLAPRN11033319367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine