Basic Information
| Provider Information | |||||||||
| NPI: | 1821475534 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KRUPSKI | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 411 LAUREL ST | ||||||||
| Address2: | SUITE 3170 | ||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503143017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152830463 | ||||||||
| FaxNumber: | 5152830794 | ||||||||
| Practice Location | |||||||||
| Address1: | 411 LAUREL ST | ||||||||
| Address2: | SUITE 3170 | ||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503143017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152830463 | ||||||||
| FaxNumber: | 5152830794 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2015 | ||||||||
| LastUpdateDate: | 09/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | D139868 | IA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 101413 | NE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.