Dr. Nicole R. Kruger, Psy.D.
Psychologist, Clinical in Ellisville, MO. Individual provider (NPI-1).
NPI number1154428076
StatusActive
Last updated in NPPESMar 23, 2011
Details
- NPI
- 1154428076
- Entity type
- Individual (NPI-1)
- Name
- Dr. Nicole R. Kruger
- Credential
- Psy.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 20, 2006
- Last updated
- Mar 23, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 2010042353 | MO | Yes |
Practice location
249 Clarkson RdSuite 102
Ellisville, MO 63011-2219
Phone 515-557-0560
Mailing address
249 Clarkson RdSuite 102
Ellisville, MO 63011-2219
Phone 515-557-0560
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All 8 Clinical Psychologist providers in Ellisville · All 400 providers in Ellisville
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