Individual
MRS. KENDAL WAGNER KRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1000 GREG KRUSCHEK AVENUE, NOME, AK 99762
(907) 443-4589
Mailing address
PO BOX 996, NOME, AK 99762
(907) 443-3311
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
347
AK
Other
Enumeration date
11/19/2014
Last updated
10/14/2015
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