Individual
ERIN PAIGE KRUCKENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
916 19TH ST, WOODWARD, OK 73801-2334
(580) 238-5734
Mailing address
729 CENTER ST, ALVA, OK 73717-2107
(405) 229-6401
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2828
OK
Other
Enumeration date
12/27/2017
Last updated
10/06/2022
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