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Individual

CYNTHIA D KRUSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
68830 CHESTNUT DR, SISTERS, OR 97759-9601
(541) 788-2231
Mailing address
68830 CHESTNUT DR, SISTERS, OR 97759-9601
(541) 788-2231

Taxonomy

Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
0776038761
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1777765
OREGON DRIVERS LICENSE
OR
Enumeration date
05/04/2021
Last updated
05/04/2021
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