Carol Krupa, PA
Individual provider Active NPI Physician Assistant · Ladysmith, WI
NPI 1972604965 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1972604965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 285 (WI)
- Practice address
- 906 College Ave West
Ladysmith, WI 54848 - Phone
- (715) 532-2345
- NPI assigned
- Sep 25, 2006
- 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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 285 | WI | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 285 | WI | Yes |
Addresses
Primary practice location
906 College Ave West
Ladysmith, WI 54848
Mailing address
1000 N Oak Ave
Marshfield, WI 54449-5777
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42914200 | Medicaid | WI |
Other providers in Ladysmith, WI
- Ashley Marie Klinner
- Becky Jean Komro
- Erin S. Konichek
- Kendra Kopecky
- Michelle Marie Krell
- Ladysmith Adult Day Services
- Ladysmith Foods Inc.
- Ladysmith Living Center, Inc
- Ladysmith Nursing Home Inc
- Ladysmith-Hawkins School District
All providers in Ladysmith, WI · Physician Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.