Krueger, Shannon M

Krueger, Shannon M is an individual health care provider with primary practice located at 2300 N Rockton Ave , Rockford IL 61103-3619. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Krueger, Shannon M can be contacted via phone (815) 971-2726.

Contact Information

Primary practice address
2300 N Rockton Ave Rockford IL 61103-3619
Phone: (815) 971-2726
Fax: (815) 971-9813
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 209007215 Illinois

Profile Details

NPI number 1891942710
LBN Legal business name Krueger, Shannon M
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2008
Last updated Mar 4th, 2014 - about 12 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 1891942710 NPPES
Illinois Other 209007215 APN LICENSE

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