Provider Demographics
NPI:1801948765
Name:CRUSE, CAROLEE SANDE (RN)
Entity type:Individual
Prefix:MS
First Name:CAROLEE
Middle Name:SANDE
Last Name:CRUSE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:CAROLEE
Other - Middle Name:SANDE
Other - Last Name:CRUSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:8330 E OSBORN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5904
Mailing Address - Country:US
Mailing Address - Phone:480-484-2811
Mailing Address - Fax:480-484-2801
Practice Address - Street 1:8330 E OSBORN RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5904
Practice Address - Country:US
Practice Address - Phone:480-484-2811
Practice Address - Fax:480-484-2801
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN051598163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ626286OtherACCESS