Provider Demographics
NPI:1003678996
Name:KRUSE, KATIE LEE (RN)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LEE
Last Name:KRUSE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E FINCH ST
Mailing Address - Street 2:
Mailing Address - City:LEIGH
Mailing Address - State:NE
Mailing Address - Zip Code:68643-5507
Mailing Address - Country:US
Mailing Address - Phone:402-660-6687
Mailing Address - Fax:
Practice Address - Street 1:510 E FINCH ST
Practice Address - Street 2:
Practice Address - City:LEIGH
Practice Address - State:NE
Practice Address - Zip Code:68643-5507
Practice Address - Country:US
Practice Address - Phone:402-660-6687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE82119163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool