Shannon M Krueger in Rockford - Pediatrics
Shannon M Krueger - NPI 1891942710
Shannon M Krueger is a Pediatrics in Rockford, Illinois. Shannon M Krueger practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Shannon M Krueger is 1891942710. The last update date is 2014-03-04.
Shannon M Krueger's current location address is 2300 N Rockton Ave, Rockford, Illinois. You can contact this provider via phone number 8159712726 and fax number 8159719813. The mailing address for Shannon M Krueger is 2300 N Rockton Ave, Rockford, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shannon M Krueger |
|---|---|
| Address | 2300 N Rockton Ave, Rockford, Illinois |
| Phone Number | 8159712726 |
| Fax Number | 8159719813 |
| Sole Proprietor | N |
| Credentials | APN |
NPI Number Detail
| NPI Number | 1891942710 |
|---|---|
| Provider Enumeration Date | 2008-08-21 |
| Last Updated Date | 2014-03-04 |
Provider Mailing Address Detail
| Address | 2300 N Rockton Ave |
|---|---|
| City | Rockford |
| State | Illinois (IL) |
| Post Code | 611033619 |
| Phone Number | 8159712726 |
| Fax Number | 8159719813 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 363Lp0200X |
| Licence No | 209007215 |
|
Definition: An advanced practice registered nurse expert in providing care to infants, children and adolescents. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 209007215 | IL | APN LICENSE |
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What is the Shannon M Krueger's unique identification number?
The Shannon M Krueger has been assigned the NPI (National Provider Identifier) Number 1891942710 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Shannon M Krueger located?
The Shannon M Krueger is located at 2300 N Rockton Ave, Rockford, IL 611033619.
What is the Shannon M Krueger's specialty and taxonomy code?
The Shannon M Krueger's specialty is Pediatrics, and the corresponding taxonomy code is 363Lp0200X.
On what date did the Shannon M Krueger receive the assignment of its 1891942710 from the Centers for Medicare & Medicaid Services?
The Shannon M Krueger was issued its 1891942710 by the Centers for Medicare & Medicaid Services on 2008-08-21.
As of what date were the details pertaining to Shannon M Krueger last refreshed?
The information related to the Shannon M Krueger, including its address, specialty, and other relevant details, was last updated on 2014-03-04.
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