Provider Demographics
NPI:1255129086
Name:KRUSE, CARRIE A
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:A
Last Name:KRUSE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:A
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:802 CUSTER AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-0859
Mailing Address - Country:US
Mailing Address - Phone:402-649-1381
Mailing Address - Fax:
Practice Address - Street 1:802 CUSTER AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-0859
Practice Address - Country:US
Practice Address - Phone:402-649-1381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider