Krueger, Mary Kathleen

Krueger, Mary Kathleen is an sole proprietor health care provider with primary practice located at 6975 W 130Th St , Parma Heights OH 44130-7821. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Krueger, Mary Kathleen can be contacted via phone (440) 888-7487.

Contact Information

Primary practice address
6975 W 130Th St Parma Heights OH 44130-7821
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X APRN..CNP.023164 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN.CNP.023164 Ohio

Profile Details

NPI number 1871077032
LBN Legal business name Krueger, Mary Kathleen
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 24th, 2018
Last updated Mar 5th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871077032 NPPES
Ohio MEDICAID 2879461

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