Provider Demographics
NPI:1871310797
Name:KRIENKE, SUZANNE C
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:C
Last Name:KRIENKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1259 84TH ST NE
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-3104
Mailing Address - Country:US
Mailing Address - Phone:763-377-2346
Mailing Address - Fax:
Practice Address - Street 1:1259 84TH ST NE
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-3104
Practice Address - Country:US
Practice Address - Phone:763-377-2346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula