Provider Demographics
NPI:1699723080
Name:KRUGER, SARAH T (NP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:T
Last Name:KRUGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2901 W BELTLINE HWY
Mailing Address - Street 2:STE 120
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4226
Mailing Address - Country:US
Mailing Address - Phone:608-443-5603
Mailing Address - Fax:608-441-1981
Practice Address - Street 1:3434 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-4155
Practice Address - Country:US
Practice Address - Phone:608-443-5480
Practice Address - Fax:608-443-5554
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI1978-033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41175700Medicaid
WI115722-30OtherRN WI LICENSE
WI084474150Medicare PIN
WIP00050913Medicare PIN
P93939Medicare UPIN