Individual
JORDAN KATSUMI KRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, FNP
Contact information
Practice address
1245 S MAIN ST, WILLITS, CA 95490-4305
(760) 496-8102
Mailing address
31262 PUDDING CREEK RD UNIT B, FORT BRAGG, CA 95437-8155
(760) 496-8102
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
95135914
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
95030155
CA
Other
Enumeration date
07/26/2025
Last updated
07/26/2025
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