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Individual

MRS. DANIELE R KROUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, LAT, ATC

Contact information

Practice address
900 HILLIGOSS BLVD SE, FOSSTON, MN 56542-1599
(218) 435-1212
Mailing address
900 HILLIGOSS BLVD SE, FOSSTON, MN 56542-1599
(218) 435-1212

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2623
MN
363A00000X
Physician Assistant
Primary
14531
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14531
STATE MEDICAL BOARD
MN
01
2623
STATE MEDICAL BOARD
MN
Enumeration date
04/09/2015
Last updated
08/02/2023
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