Provider Demographics
NPI:1881129542
Name:KROUSE, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:KROUSE
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 1:61 NANCY AVE
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2632
Mailing Address - Country:US
Mailing Address - Phone:978-660-1164
Mailing Address - Fax:
Practice Address - Street 1:61 NANCY AVE
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2632
Practice Address - Country:US
Practice Address - Phone:978-660-1164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN181330163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse