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Individual

JENNIE REBECCA KRULL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
555 S PERRYVILLE RD STE 130, ROCKFORD, IL 61108-2527
(815) 995-2201
(224) 999-4002
Mailing address
1050 COUNTRY CLUB RD UNIT 386, WOODSTOCK, IL 60098-5585
(815) 501-5048

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
277000398
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
377000394
IL

Other

Enumeration date
12/18/2015
Last updated
09/02/2025
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