Basic Information
| Provider Information | |||||||||
| NPI: | 1306287016 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRUGER | ||||||||
| FirstName: | ALISSA | ||||||||
| MiddleName: | RENAE | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 403 1ST ST SE | ||||||||
| Address2: | |||||||||
| City: | BELMOND | ||||||||
| State: | IA | ||||||||
| PostalCode: | 504211201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6414443500 | ||||||||
| FaxNumber: | 6414445688 | ||||||||
| Practice Location | |||||||||
| Address1: | 4949 WESTOWN PKWY | ||||||||
| Address2: | STE 100 | ||||||||
| City: | WEST DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 502666704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5153272000 | ||||||||
| FaxNumber: | 5153272019 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2013 | ||||||||
| LastUpdateDate: | 05/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | A122730 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.