Provider Demographics
NPI:1275123903
Name:KRUEGER, KRISTI JO (FNP)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:JO
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 GARDEN BROOK DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-7886
Mailing Address - Country:US
Mailing Address - Phone:719-351-9175
Mailing Address - Fax:
Practice Address - Street 1:226 GARDEN BROOK DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-7886
Practice Address - Country:US
Practice Address - Phone:719-351-9175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-163577207Q00000X, 363LF0000X, 2080P0006X, 363LP0200X, 363L00000X, 207QA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine