Provider Demographics
NPI:1164112710
Name:KRUSER, SIERRA LYN (PA-C)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:LYN
Last Name:KRUSER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-632-7500
Mailing Address - Fax:617-632-7522
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-632-7500
Practice Address - Fax:617-632-7522
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2024-03-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant