Individual
SARA L KRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 HOSPITAL DR, LEBANON, MO 65536-9210
(417) 533-6026
Mailing address
100 HOSPITAL DR, LEBANON, MO 65536-9210
(417) 533-6026
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2001003778
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235443797
—
MO
05
—
183462001
—
AR
01
—
431560263
TRICARE WEST
—
01
—
P00851999
RAILROAD MEDICARE GROUP # CB9013
—
Enumeration date
07/27/2010
Last updated
04/14/2022
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