Provider Demographics
NPI:1265562680
Name:KRUG, BARBARA JANE (LPN)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JANE
Last Name:KRUG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8764 WASHINGTON COLONY DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45458-3313
Mailing Address - Country:US
Mailing Address - Phone:937-245-0048
Mailing Address - Fax:937-245-0048
Practice Address - Street 1:8764 WASHINGTON COLONY DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45458-3313
Practice Address - Country:US
Practice Address - Phone:937-245-0048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2016-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN115185164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPN2523700Medicaid