Provider Demographics
NPI:1114671245
Name:KRUSE, PAIGE (PA-C)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:KRUSE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-9270
Mailing Address - Country:US
Mailing Address - Phone:205-664-9995
Mailing Address - Fax:
Practice Address - Street 1:408 1ST ST N
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-9270
Practice Address - Country:US
Practice Address - Phone:262-745-7455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant