Provider Demographics
NPI:1477380640
Name:KRUSE, ELIZABETH ANNE
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:KRUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 MILL ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:IA
Mailing Address - Zip Code:51001-7712
Mailing Address - Country:US
Mailing Address - Phone:712-556-2411
Mailing Address - Fax:
Practice Address - Street 1:14153 IMPALA AVE
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-8360
Practice Address - Country:US
Practice Address - Phone:712-539-3051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF07240037363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily