Carmen Krug, SLP
Individual provider Active NPI Speech-Language Pathologist · Deforest, WI
NPI 1407428121 · NPPES record last updated Oct 26, 2022
Key facts
- NPI
- 1407428121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 5297-154 (WI)
- Practice address
- 300 Cheyenne CT
Deforest, WI 53532-1007 - Phone
- (608) 516-3702
- NPI assigned
- Jul 13, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5297 | WI | MD | Prosthodontist |
| 5297-154 | WI | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5297 | WI | |
| Speech-Language Pathologist | 235Z00000X | 5297-154 | WI | Yes |
Addresses
Primary practice location
300 Cheyenne CT
Deforest, WI 53532-1007
Mailing address
300 Cheyenne CT
Deforest, WI 53532-1007
Phone (608) 516-3702
Other providers in Deforest, WI
- Jat Pharmacy, LLC
- Julie Christine Jones
- Torina Ruth Kehoe
- Farah Khan
- Daniel R Knuteson
- Scott Curtis Landon
- Julie Lederman
- Mercedes Yasmine Lewis
- Jamie Lothe
- MCN Madison LLC
All providers in Deforest, WI · Speech-Language Pathologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.