Individual
SHANNON M KRUEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2300 N ROCKTON AVE, ROCKFORD, IL 61103-3619
(815) 971-2726
(815) 971-9813
Mailing address
2300 N ROCKTON AVE, ROCKFORD, IL 61103-3619
(815) 971-2726
(815) 971-9813
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209007215
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209007215
APN LICENSE
IL
Enumeration date
08/21/2008
Last updated
03/04/2014
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