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Individual

MS. KATHARINE ROSE CRUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
2101 LINCOLN FARM RD, HODGENVILLE, KY 42748-9704
(844) 435-0900
(270) 858-4029
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 858-6655
(270) 858-4607

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3008326
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12667985
CAQH
01
3008326
STATE LICENSE
KY
05
7100290900
KY
Enumeration date
03/25/2014
Last updated
05/12/2023
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