Individual
MICHELE A KRUCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CLC
Contact information
Practice address
4410 REGENT ST, MADISON, WI 53705-4901
(608) 233-9746
(608) 233-9993
Mailing address
N1639 FJORD CIR, PRAIRIE DU SAC, WI 53578-9551
(608) 576-7894
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
168199-030
WI
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
207511
WI
Other
Enumeration date
11/25/2009
Last updated
12/12/2014
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