Provider Demographics
NPI:1508073156
Name:WILLIAMSON-KRUSE, LORI (MS)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:
Last Name:WILLIAMSON-KRUSE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:OU CHILDREN'S PHYSICIANS, 940 NE 13TH
Mailing Address - Street 2:RM B2418
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104
Mailing Address - Country:US
Mailing Address - Phone:405-271-8685
Mailing Address - Fax:405-271-8697
Practice Address - Street 1:940 NE 13TH ST
Practice Address - Street 2:OU CHILDREN'S PHYSICIANS, RM B2418
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5008
Practice Address - Country:US
Practice Address - Phone:405-271-8685
Practice Address - Fax:405-271-8697
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS