Individual
SAMANTHA JO CRUSENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
650 S WALKER ST, BLOOMINGTON, IN 47403-2158
(812) 334-0698
Mailing address
650 S WALKER ST, BLOOMINGTON, IN 47403-2158
(812) 334-0698
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
28222223A
IN
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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