Individual
STACY RAE KREGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
524 SPRUCE ST STE 5, BROOKINGS, OR 97415-0407
(541) 813-1505
(541) 813-1506
Mailing address
PO BOX 488, BROOKINGS, OR 97415-0043
(154) 181-3150
(541) 813-1506
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
201900396
OR
Other
Enumeration date
01/16/2019
Last updated
01/03/2024
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