Individual
DR. NICOLE R. KRUGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
249 CLARKSON RD, SUITE 102, ELLISVILLE, MO 63011-2219
(515) 557-0560
Mailing address
249 CLARKSON RD, SUITE 102, ELLISVILLE, MO 63011-2219
(515) 557-0560
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2010042353
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02934
WELLMARK BLUE CROSS
IA
01
—
42105384450265A022
TRIWEST
IA
01
—
7522737
MIDLANDS CHOICE
IA
Enumeration date
09/20/2006
Last updated
03/23/2011
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