Jennie Rebecca Krull, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

377000394 Issued in IL

Practice address

555 S Perryville Rd Ste 130
Rockford, IL 61108-2527

Phone

(815) 995-2201

Fax

(224) 999-4002

NPI assigned

Dec 18, 2015

Last updated

Jun 9, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Mindplexity Psychiatric Services PLLCGroup PAC ID 9032596788, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.jenniekrull@146897.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindplexity Psychiatric Services, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rockford, IL
  • NPI 1437808433
  Medicare reassignment Care Compare group NPD Authorized official
• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Positive Pathways Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Joliet, IL
  • NPI 1447148960
  NPD
• Psychology Specialists LTD

  dba LifeStance Health

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1518322510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 COUNTRY CLUB RD UNIT 386",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600985585",
            "telephone_number": "815-501-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S PERRYVILLE RD STE 130",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082527",
            "telephone_number": "815-995-2201",
            "fax_number": "224-999-4002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Lions Dr Ste 221",
            "address_purpose": "LOCATION",
            "city": "Barrington",
            "state": "IL",
            "postal_code": "600103175",
            "country_code": "US",
            "telephone_number": "847-865-4125",
            "fax_number": "847-859-5885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRULL",
        "first_name": "JENNIE",
        "middle_name": "REBECCA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "IL",
            "license": "277000398",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "IL",
            "license": "277000398",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "377000394",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277000398",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy L. Krolow, OTR, CHT
• Philip Michael Krolow
• Amy Lynn Kroos, NP
• Kelsey L Krotiak, DPM
• Shannon M Krueger, APN
• Dana Kruse, RBT -17-34424
• Kathleen A Kruse
• Bianka Sara Ksiazek, DPM
• Lisa M Kubelka
• Tammy M Kucia, PA C

• Psychiatric/Mental Health Nurse Practitioner in Rockford, IL
• Providers in Rockford, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.