Provider Demographics
NPI:1437180478
Name:CRUEY, KAREN LEAH (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LEAH
Last Name:CRUEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2340 PASEO DEL PRADO
Mailing Address - Street 2:SUITE D207
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4360
Mailing Address - Country:US
Mailing Address - Phone:702-247-1703
Mailing Address - Fax:702-247-4082
Practice Address - Street 1:530 W 27TH ST # 515B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-3203
Practice Address - Country:US
Practice Address - Phone:702-247-1703
Practice Address - Fax:702-247-4082
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV85062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVG65011Medicare UPIN
NV30629Medicare ID - Type UnspecifiedMEDICARE NUMBER