Individual
KELLY LAVONNE KRUSE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2020 COUNTY ROAD Z, BLUE MOUNDS, WI 53517-9629
(608) 437-6035
(608) 437-6035
Mailing address
2020 COUNTY ROAD Z, BLUE MOUNDS, WI 53517-9629
(608) 437-6035
(608) 437-6035
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
84725-030
WI
Other
Enumeration date
05/08/2006
Last updated
07/08/2007
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