Individual
MR. JEFFREY THOMAS VAUGHAN KROEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
13250 WASHINGTON AVE, MOUNT PLEASANT, WI 53177-1516
(262) 799-8700
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
133302-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100008524
—
WI
Enumeration date
01/13/2010
Last updated
12/26/2024
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