Individual
BEVERLY KRUISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
105 HUNTER XING APT 105, BOSSIER CITY, LA 71111-8125
(318) 349-1635
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN157206
LA
Other
Enumeration date
03/21/2022
Last updated
03/21/2022
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