Individual
LYNDA K KRUCKEBERG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
310 BELLE AVE, MANKATO, MN 56001-5287
(507) 387-5581
Mailing address
1402 PARKSIDE LN, NORTH MANKATO, MN 56003-3232
(507) 386-0066
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R116090-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-03374
MEDICA
—
01
—
1017704
PREFERRED ONE
—
01
—
120812
UCARE
—
01
—
1836755
AMERICA'S PPO (ARAZ)
—
01
—
28737
SIOUX VALLEY HEALTH PLAN
—
01
—
287R2KR
BCBS MN
MN
01
—
HP23670
HEALTH PARTNERS
—
Enumeration date
01/25/2006
Last updated
07/08/2007
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