Individual provider Active NPI

Melissa Ann Krull, LPN

  • Licensed Practical Nurse
  • Anchorage, AK
National Provider Identifier
1083176200
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
138513 Issued in AK
Practice address
670 W Fireweed LN Ste 160
Anchorage, AK 99503-2561
Phone
(907) 770-0862
NPI assigned
Apr 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 138513 AK Primary

Addresses

Primary practice location

670 W Fireweed LN Ste 160
Anchorage, AK 99503-2561

Mailing address

2247 Greenleaf Rd
De Pere, WI 54115-8621
Phone (920) 606-9692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
138513AKMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1083176200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2247 GREENLEAF RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541158621",
            "telephone_number": "920-606-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 W FIREWEED LN STE 160",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032561",
            "telephone_number": "907-770-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRULL",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AK",
            "license": "138513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.