Individual
STACY L KRUEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2251
(701) 234-2050
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R32343
ND
Other
Enumeration date
07/24/2012
Last updated
07/24/2012
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