Individual
ANDREA KRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
190 E. BANOCK ST., BOISE, ID 83712
(208) 381-2222
Mailing address
11358 W TIOGA ST, BOISE, ID 83709-3347
(208) 890-0848
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
5421
ID
Other
Enumeration date
08/16/2023
Last updated
08/16/2023
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