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Contact Information

SHANNON D KRUEGER
430 N MONTE VISTA ST
ADA, OK74820-4610
 Phone: 580-421-1511
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diabetes Educator

163WD0400X
Indicates primary specialty

NPI Profile & details for SHANNON D KRUEGER · (Female)

NPI Number 1033764378
Status Active
Credentials
Entity Individual
Enumeration date 08/05/2019
Last updated 08/05/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • TX License # 754947
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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