JON RUSSELL KRUEGER (NPI# 1033473749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033473749 |
| Entity Type | Individual |
| Full Name | JON RUSSELL KRUEGER |
| Credential | PMHNP |
| Practice Address |
420 W 5th Ave Flint MI 48503-2445 |
| Practice Telephone | (810) 257-3736 |
| Practice Fax Number | 9897231205 |
| Mailing Telephone | (810) 257-3736 |
| Mailing Fax Number | 9897231205 |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
4704205426 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 721 N Shiawassee St, Suite 201, Owosso, MI 488671632 | 9897258124 | 9897231205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528517661 | Jon P Krueger | Nurse Practitioner | 975 Port Washington Rd, Grafton, WI 53024-9201 | 2016-09-30 |
| 1073994034 | Jon Krueger | Counselor | 759 Columbus Ave, Lebanon, OH 45036-1754 | 2015-06-16 |
| Street Address |
420 W 5TH AVE |
| City | FLINT |
| State | MI |
| Zip Code | 48503-2445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235115460 | County of Genesee Office of Controller | Preventive Medicine | 420 W 5th Ave, Flint, MI 48503 | 2005-12-20 |
| 1245837640 | Angela Marie Strom | Registered Nurse | 420 W 5th Ave, Flint, MI 48503-2445 | 2020-10-08 |
| 1841897246 | Avalena Ann Lessard | Case Manager/Care Coordinator | 420 W 5th Ave, Flint, MI 48503-2445 | 2020-10-08 |
| 1891309258 | Dawn Michelle Smith | Social Worker | 420 W 5th Ave, Flint, MI 48503-2445 | 2020-09-03 |
| 1881203834 | Teevia C Brown | Psychologist | 420 W 5th Ave, Flint, MI 48503-2445 | 2020-07-27 |
| 1811515018 | Tashara Monique Ewing | Case Manager/Care Coordinator | 420 W 5th Ave, Flint, MI 48503-2445 | 2020-07-14 |
| 1265053508 | Kaleea Preuss-harper | Case Manager/Care Coordinator | 420 W 5th Ave, Flint, MI 48503-2445 | 2020-04-28 |
| 1285269969 | Richard L Neenan IIi | Case Manager/Care Coordinator | 420 W 5th Ave, Flint, MI 48503-2445 | 2020-03-03 |
| 1518590405 | Erik Kahn | Case Manager/Care Coordinator | 420 W 5th Ave, Flint, MI 48503-2445 | 2020-02-19 |
| 1346870961 | Lanora Cooper | Case Manager/Care Coordinator | 420 W 5th Ave, Flint, MI 48503-2445 | 2020-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457971640 | Flint Odyssey House Inc. | Community/Behavioral Health | 1219 Martin Luther King Avenue, Flint, MI 48503 | 2020-04-17 |
| 1891265476 | Mary Margaret Woodruff | Health Educator | 411 E. Third St Suite 2, Flint, MI 48503 | 2018-11-27 |
| 1669942223 | Donna Jean Phelps | Behavior Technician | 2284 S Ballenger Highway, Flint, MI 48503 | 2018-11-27 |
| 1588150601 | Dayonna Scott | Social Worker | Hope Network, 2830 Corunna Rd, Flint, MI 48503 | 2018-07-02 |
| 1801388020 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2284 S Ballenger Hwy Ste F, Flint, MI 48503 | 2018-06-04 |
| 1134610504 | Swathi Gorle | Student in an Organized Health Care Education/Training Program | Hurley Medical Center, 1 Hurley Plaza, Flint, MI 48503 | 2018-05-22 |
| 1881128049 | Kara Garr | Registered Nurse | 805 Tuuri Pl, Flint, MI 48503 | 2017-04-14 |
| 1518405638 | Thomasinia Terrell | Peer Specialist | 422 W Fourth Ave, Flint, MI 48503 | 2017-02-09 |
| 1790231041 | Roslyn Boyce | Technician, Other | 2213 E. Court Street, Flint, MI 48503 | 2016-08-28 |
| 1689120818 | Yasmine Elhefnawy | Student in an Organized Health Care Education/Training Program | One Hurley Plaza 3d West, Flint, MI 48503 | 2016-08-28 |
| Find all providers in zip 48503 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316551047 | Stella I Osuagwu | Nurse Practitioner | 5300 Meadow Ct, Flint, TX 75762-9713 | 2020-09-01 |
| 1679609002 | Kandice K. Andrews | Nurse Practitioner | 420 W Fifth Avenue, Flint, MI 48503-5902 | 2007-02-27 |
| 1861400376 | Marjorie Lee Ferguson | Nurse Practitioner | Va Flint Healthcare System, G-3267 Beecher Rd, Flint, MI 48532 | 2006-08-03 |
| 1992321830 | Brittany Radler | Nurse Practitioner | 1 Hurley Plz, Flint, MI 48503-5902 | 2020-06-16 |
| 1740431998 | Jackie Lee Duncan | Nurse Practitioner | 1110 Eldon Baker Dr, Flint, MI 48507-1923 | 2008-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692494 | Memphis Chardell Sandoval | Nurse Practitioner | 131 S. Seaway Dr., Muskegon, MI 49441 | 2020-09-01 |
| 1588282784 | Mary Tackbary | Nurse Practitioner | 3932 W Briar Hill Dr, Maple City, MI 49664-9521 | 2020-07-14 |
| 1962032227 | Westlake Consultation Center | Nurse Practitioner | 4870 W Clark Rd Ste 100, Ypsilanti, MI 48197-1104 | 2020-01-24 |
| 1689211823 | Wanda Edwards | Nurse Practitioner | 29000 Inkster Rd Ste 115, Southfield, MI 48034-1097 | 2019-12-06 |
| 1508416355 | Stephanie Lauren Marl | Nurse Practitioner | 29800 Adams Dr, Gibraltar, MI 48173 | 2019-09-13 |
| 1457905614 | Natalie Poole | Nurse Practitioner | 23077 Greenfield Rd Ste 260, Southfield, MI 48075-3745 | 2019-07-26 |
| 1629535117 | Valerie Baunoch | Nurse Practitioner | 2057 E West Maple Rd, Commerce Twp, MI 48390 | 2019-02-21 |
| 1790293488 | Infinity Hope Center LLC | Nurse Practitioner | 260 Vinewood St Ste 100a8919, Detroit, MI 48216-1667 | 2018-01-16 |
| 1033659644 | Anne Zamler | Nurse Practitioner | 14230 W Mcnichols Rd, Detroit, MI 48235-3912 | 2017-03-01 |
| 1396289120 | Next Level Up Health & Wellness Inc. | Nurse Practitioner | 28423 Parkwood St, Inkster, MI 48141-1669 | 2016-12-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.