Provider Demographics
NPI:1134090210
Name:KRUEGER, BAYLIE
Entity type:Individual
Prefix:
First Name:BAYLIE
Middle Name:
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 REYNOLDS AVE
Mailing Address - Street 2:
Mailing Address - City:SWINK
Mailing Address - State:CO
Mailing Address - Zip Code:81077-5040
Mailing Address - Country:US
Mailing Address - Phone:719-469-6092
Mailing Address - Fax:
Practice Address - Street 1:5000 SAINT PAUL AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-2760
Practice Address - Country:US
Practice Address - Phone:402-466-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-13
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer