Provider Demographics
NPI:1891196135
Name:CRUSE, JULIE (APRN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:CRUSE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33566-0925
Mailing Address - Country:US
Mailing Address - Phone:512-550-0079
Mailing Address - Fax:
Practice Address - Street 1:35 SE 1ST AVE STE 200J
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2177
Practice Address - Country:US
Practice Address - Phone:352-234-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020353363LA2100X, 363LF0000X, 363LP0808X
COC-APN.0002708-C-NP363LA2100X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily