1083939375 NPI number — MRS. COLLEEN LOUISE KRAJEWSKI C.R.N.P.

Table of content: MRS. COLLEEN LOUISE KRAJEWSKI C.R.N.P. (NPI 1083939375)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083939375 NPI number — MRS. COLLEEN LOUISE KRAJEWSKI C.R.N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRAJEWSKI
Provider First Name:
COLLEEN
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
C.R.N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083939375
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3400 LONG PRAIRIE RD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLOWER MOUND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75022-2953
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-899-6300
Provider Business Mailing Address Fax Number:
972-899-6020

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8440 WALNUT HILL LN STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75231-3803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-879-9966
Provider Business Practice Location Address Fax Number:
214-267-8999
Provider Enumeration Date:
03/30/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP140723 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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