NPI 1033764378 · live from the CMS NPI Registry
Shannon D Krueger
Registered Nurse, Diabetes Educator in Ada, OK. National Provider Identifier 1033764378, active.
NPI record
| NPI | 1033764378 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Registered Nurse, Diabetes Educator 163WD0400X |
| Practice location | 430 N Monte Vista St, Ada, OK 74820 |
| Practice phone | 580-421-1511 |
| Enumerated | August 5, 2019 |
| Last updated | August 5, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Diabetes Educator primary | 163WD0400X | 754947 (TX) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.