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Individual

MRS. TINA NICOLE CRUSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.S.

Contact information

Practice address
1351 NEWTOWN PIKE, LEXINGTON, KY 40511-1275
(859) 271-9448
(859) 272-6893
Mailing address
1351 NEWTOWN PIKE, LEXINGTON, KY 40511-1275
(859) 271-9448
(859) 272-6893

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790731081
KY
Enumeration date
10/14/2014
Last updated
10/28/2014
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