Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | BP10043355 | TX |
NPI | 1013270867 |
---|---|
Provider Name | Dr. Katrina Marie Von Kriegenbergh |
First Address | Lubbock, TX 79430-0001 |
Second Address | Lubbock, TX 79430-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2012 |
Last Update Date | 02/08/2016 |